| 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 |
| 收稿日期:2019-01-14 出版日期:2019-07-17 |
| 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 |
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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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