文章摘要
孙燕,赵清霞,李超锋,杨萱,张雪,刘春礼,陈昭云.河南省2003-2005年HIV/AIDS抗病毒治疗随访10年生存状况分析[J].中华流行病学杂志,2018,39(7):966-970
河南省2003-2005年HIV/AIDS抗病毒治疗随访10年生存状况分析
Analysis on 10 year survival of HIV/AIDS patients receiving antiretroviral therapy during 2003-2005 in Henan province
投稿时间:2017-12-26  
DOI:10.3760/cma.j.issn.0254-6450.2018.07.019
中文关键词: 艾滋病;抗病毒治疗;生存分析;长期;影响因素
英文关键词: HIV/AIDS;Antiretroviral therapy;Survival analysis;Long-term;Influencing factors
基金项目:国家科技重大专项(2012ZX10001-003-001);河南省科技攻关计划项目(162102310217)
作者单位E-mail
孙燕 450015 郑州市第六人民医院感染科  
赵清霞 450015 郑州市第六人民医院感染科  
李超锋 450015 郑州市第六人民医院感染科  
杨萱 450015 郑州市第六人民医院感染科  
张雪 450015 郑州市第六人民医院感染科  
刘春礼 450015 郑州市第六人民医院感染科  
陈昭云 450015 郑州市第六人民医院感染科 chenzhaoyun@126.com 
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中文摘要:
      目的 分析河南省艾滋病感染者和艾滋病患者(HIV/AIDS)抗病毒治疗(antiretroviral therapy,ART)10年生存状况及影响长期生存的因素。方法 利用国家艾滋病抗病毒治疗数据库,收集河南省2003-2005年接受ART的HIV/AIDS基本情况和治疗随访信息,采用寿命表法和Cox比例风险模型分析生存状况和影响长期生存的危险因素,采用SPSS 23.0软件进行统计分析。结果 2003-2005年开始ART的2 448例HIV/AIDS中,男性占53.5%(1 309/2 448),女性占46.5%(1 139/2 448),40~59岁占70.1%(1 715/2 448),以血液传播为主,占95.5%(2 337/2 448);ART后随访10年,死于艾滋病及相关疾病719例,死亡率为3.78/100人年(719/19 010人年);患者第1、3、5、10年累计生存率为0.94、0.86、0.78、0.69。相对于年龄<40岁组,40~、50~、60~和≥70岁组HR值(95% CI)分别为1.417(0.903~2.222)、1.834(1.174~2.866)、2.422(1.539~3.810)和3.424(2.053~5.709);相对于基线CD4+T淋巴细胞(CD4)>350个/μl,CD4<50、50~199、200~350个/μl的HR值(95% CI)值分别为7.105(5.449~9.264)、4.175(3.249~5.366)和2.214(1.691~2.900);男性相对于女性HR=1.480(95% CI:1.273~1.172)、没有更换二线治疗HR=11.923(95% CI:9.410~15.104)。结论 河南省早期HIV/AIDS接受ART 10年后的累计生存率为0.69,男性、年龄较大、基线CD4水平低、未及时更换二线抗病毒药物为影响其长期生存的危险因素。
英文摘要:
      Objective To understand the survival of HIV/AIDS patients after receiving antiretroviral therapy for 10 year in Henan province and related factors. Methods The database of national integrated management system of HIV/AIDS was used to collect the basic information and follow-up information of HIV/AIDS patients who received antiretroviral therapy between 2003 and 2005 in Henan province. Software SPSS 23.0 was used to analyze the patients' survival and related factors based on the life-table method and Cox proportional hazards model. Results Among the 2 448 HIV/AIDS patients who started antiretroviral therapy during 2003-2005, the men accounted for 53.5%, and women accounted for 46.5%. Up to 70.1% of the patients were aged 40-59 years and 95.5% of the patients had blood borne infections. The patients were observed for 10 years after antiviral treatment, and 719 cases died from AIDS related diseases, with a mortality rate of 3.78/100 per year (719/19 010 per year). The cumulative survival rates of patients within 1-year, 3 years, 5 years and 10 years were 0.94, 0.86, 0.78, 0.69 respectively. Compared with the patients aged <40 years, the HRs of the patients aged 40-, 50-, 60-and ≥ 70 years were 1.417 (95%CI:0.903-2.222), 1.834 (95%CI:1.174-2.866), 2.422 (95%CI:1.539-3.810) and 3.424 (95%CI:2.053-5.709) respectively. Compared with patients with baseline CD4+T lymphocyte >350 unit/ul, the HRs of the patients with CD4+T lymphocyte <50 unit/μl, 50-199 unit/ul and 200-350 unit/ul were 7.105 (95%CI:5.449-9.264), 4.175 (95%CI:3.249-5.366) and 2.214 (95%CI:1.691-2.900) respectively. Compared with the women, the HR of the men was 1.480 (95%CI:1.273-1.172). Compared with the patients who received second line ART therapy, the HR of patients receiving no second line therapy was 11.923 (95%CI:9.410-15.104). Conclusions The cumulative survival rate the HIV/AIDS patients after 10 years of antiretroviral therapy reached 0.69 in Henan. Male, old age, low basic CD4+T lymphocyte count and receiving no second line therapy were the risk factors for long-term survival of AIDS patients.
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