文章摘要
陈洋,宋晓甜,姚永明,黄璐,安竹,袁俊,熊兵,刘跃辉,张玉琼.贵州省1996-2015年注射吸毒人群HIV/AIDS死亡率及其影响因素分析[J].中华流行病学杂志,2019,40(7):765-769
贵州省1996-2015年注射吸毒人群HIV/AIDS死亡率及其影响因素分析
Mortality and influencing factors on injecting drug users with HIV/AIDS in Guizhou province, 1996-2015
投稿时间:2019-01-14  
DOI:10.3760/cma.j.issn.0254-6450.2019.07.006
中文关键词: 注射吸毒人群;艾滋病病毒/艾滋病;死亡率;影响因素
英文关键词: Injecting drug users;HIV/AIDS;Mortality;Influencing factors
基金项目:
作者单位E-mail
陈洋 贵州省疾病预防控制中心, 贵阳 550001  
宋晓甜 贵州省疾病预防控制中心, 贵阳 550001  
姚永明 贵州省疾病预防控制中心, 贵阳 550001  
黄璐 贵州省疾病预防控制中心, 贵阳 550001  
安竹 贵州省疾病预防控制中心, 贵阳 550001  
袁俊 贵州省疾病预防控制中心, 贵阳 550001  
熊兵 贵州省疾病预防控制中心, 贵阳 550001  
刘跃辉 贵州省疾病预防控制中心, 贵阳 550001  
张玉琼 贵州省疾病预防控制中心, 贵阳 550001 1405874253@qq.com 
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中文摘要:
      目的 了解贵州省注射吸毒人群中HIV/AIDS死亡情况及其影响因素,为降低HIV/AIDS死亡率提供参考依据。方法 采用回顾性队列研究方法,以我国艾滋病防治基本信息系统中1996-2015年贵州省注射吸毒人群HIV/AIDS为研究对象,应用Cox比例风险回归模型分析其死亡的影响因素。结果 共有3 958例注射吸毒HIV/AIDS纳入分析,全死因的死亡比例为44.01%(1 742/3 958),总死亡率为7.80/100人年,生存时间M=8.08年;抗病毒治疗(ART)组死亡率为3.57/100人年,美沙酮维持治疗(MMT)组死亡率为4.08/100人年。多因素Cox回归分析结果显示,研究对象的死亡与性别、民族、确认HIV阳性时年龄、确认HIV阳性后首次CD4+T淋巴细胞计数(CD4)、ART和MMT有关;女性的死亡风险是男性的0.82倍(95% CI:0.69~0.98);少数民族的死亡风险是汉族的1.39倍(95% CI:1.21~1.60);确认HIV阳性时年龄≥50岁的死亡风险是<20岁的2.44倍(95% CI:1.07~5.56);确认HIV阳性后首次CD4≥500个/μl组的死亡风险是CD4<200个/μl组的0.27倍(95% CI:0.22~0.32);未参加ART的死亡风险是参加者的2.83倍(95% CI:2.45~3.26);未参加MMT的死亡风险是参加者的1.35倍(95% CI:1.15~1.59)。结论 1996-2015年贵州省注射吸毒人群HIV/AIDS中,男性、确认HIV阳性时年龄较大者、确认HIV阳性后首次CD4较低、未参加ART和MMT的病例,死亡风险较高。
英文摘要:
      Objective To understand the mortality and influencing factors on injecting drug users (IDUs) with HIV/AIDS, in Guizhou province, 1996-2015. Methods A retrospective cohort study was conducted on IDUs with HIV/AIDS that were reported through national comprehensive HIV/AIDS information system, in Guizhou province during 1996-2015. Cox proportional hazard regression model was used to analyze the influencing factors on the mortality of HIV/AIDS. Results A total of 3 958 cases of IDUs with HIV/AIDS were recruited in this study, with all-cause mortality rate of 44.01% (1 742/3 958) and total mortality rate of 7.80/100 person-years, respectively. The median survival time between diagnosis and death was 8.08 years. Mortality rate was 3.57/100 person- years in the group receiving antiretroviral therapy (ART). The mortality appeared to be 4.08/100 person-years in the group who were on methadone maintenance treatment (MMT). Data from the multiple regression analysis indicated that factors of gender, ethnicity, age when HIV/AIDS diagnosis was made, CD4+ T lymphocyte (CD4) count at the first testing, ART and MMT were significantly associated with deaths among these people. The risk of death in females was 0.82 times (95%CI:0.69-0.98) higher than that in males. The risk of deaths among the ethnic minority subjects was 1.39 times (95%CI:1.21-1.60) higher than that of the Hans. The risk of death appeared to be 2.44 times higher (95%CI:1.07-5.56) in the over-50-year of age group than in the <20 year-old group, when HIV/AIDS was diagnosed for the first time. The risk of death in CD4 ≥ 500/μl group in the first time was 0.27 times (95%CI:0.22-0.32) more than CD4 <200/μl group in the firs time. The risk of death in cases who were treated with ART or MMT was 2.83 times (95%CI:2.45-3.26) and 1.35 times (95%CI:1.15-1.59) higher than those who did not receive any treatment, respectively. Conclusion Higher risks on death seemed to be related to the following factors:being male, older age at the time of diagnosis, lower CD4 at diagnosis, not on ART or MMT among the IDUs with HIV/AIDS in Guizhou province, between 1996-2015.
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