| 郭燕,周宁,赵芳凝,柳忠泉,李龙,于茂河.天津市2005-2015年开始接受抗病毒治疗的HIV/AIDS生存分析[J].中华流行病学杂志,2019,40(8):936-940 |
| 天津市2005-2015年开始接受抗病毒治疗的HIV/AIDS生存分析 |
| Survival analysis on HIV/AIDS patients who began receiving antiretroviral therapy from 2005 to 2015 in Tianjin |
| 收稿日期:2019-03-04 出版日期:2019-08-19 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.08.012 |
| 中文关键词: HIV/AIDS 抗病毒治疗 生存分析 影响因素 |
| 英文关键词: HIV/AIDS Antiretroviral therapy Survival analysis Influencing factors |
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| 中文摘要: |
| 目的 了解2005-2015年天津市开始接受抗病毒治疗（ART）的HIV/AIDS生存状况及影响因素。方法 利用中国艾滋病基本信息系统收集2005-2015年天津市开始接受ART的HIV/AIDS病例的数据资料，对数据资料进行回顾性队列研究，应用寿命表法计算生存率，Cox比例风险模型分析生存时间的影响因素。结果 共纳入研究对象2 057例，其中艾滋病相关死亡病例51例，研究对象接受ART后1、3、5、10年累积生存率分别为98.4%、97.8%、97.4%、95.8%。Cox比例风险模型分析结果显示，相比于年龄<30岁组，30~、40~和≥ 50岁组的aHR值（95% CI）分别为4.506（1.226~9.059）、5.944（1.479~13.892）和15.958（5.309~27.206）；相比于ART过程无失访者，有失访者的aHR=5.645（95% CI：3.124~10.200）；相对于其他机构发现者，发现机构为医院的aHR=3.823（95% CI：1.423~10.274）；相比于ART前未感染HBV/HCV者，感染HBV/HCV者的aHR=2.580（95% CI：1.210~5.502）；相比于ART时临床分期Ⅰ/Ⅱ期者，Ⅲ/Ⅳ期者的aHR=3.947（95% CI：2.167~7.188）；相比于初中及以下文化程度者，高中及以上文化程度者的aHR=0.440（95% CI：0.238~0.810）；相比于样本来源为术前检测者，样本来源为专题调查与检测咨询的HR值（95% CI）分别为0.111（0.027~0.456）和0.182（0.049~0.674）。结论 2005-2015年天津市ART的HIV/AIDS生存率较高。ART时年龄较大、ART过程有失访、发现机构为医院、ART时感染HBV/HCV、临床分期为Ⅲ/Ⅳ期是HIV/AIDS生存的危险因素，高中及以上文化程度、样本来源为专题调查与检测咨询是HIV/AIDS生存的保护因素。 |
| 英文摘要: |
| Objective To study the survival time and influencing factors of HIV/AIDS cases who began receiving antiretroviral therapy (ART) from 2005 to 2015 in Tianjin. Methods Data related to HIV/AIDS cases that receiving ART between 2005 and 2015 in Tianjin, were collected from the Chinese HIV/AIDS Basic Information Management System. A retrospective cohort study was conducted to analyze data of collection. Life table was used to calculate the survival proportion and Cox proportion hazard regression model was used to analyze the factors associated to the time of survival. Results A total of 2 057 HIV/AIDS cases were involved, including 51 died from AIDS related disease, ending up with the survival rates of 1, 3, 5 and 10 years as 98.4%, 97.8%, 97.4% and 95.8%, respectively. Results from the multivariate Cox proportion hazard regression model showed that when comparing with the cases aged <30 years, aHR (95%CI) of the cases aged 30-39 years, 40-49 years, 50 years or above appeared as 4.506 (1.226-9.059), 5.944 (1.479-13.892) and 15.958 (5.309-27.206) respectively. When comparing with the cases having no loss of follow-up during ART process, the aHR of the cases having lost of follow-up during ART was 5.645 (95%CI:3.124-10.200). When comparing with the cases diagnosed by other institutions, the aHR of the cases diagnosed by hospitals was 3.823 (95%CI:1.423-10.274). When compared with the cases had no hepatitis B or hepatitis C before ART, aHR of the cases with hepatitis B or C prior to ART was 2.580 (95%CI:1.210-5.502). Compared with the cases receiving ART at Ⅰ/Ⅱ clinical stages, the aHR of the cases at Ⅲ/Ⅳ clinical stages was 3.947 (95%CI:2.167-7.188). Compared with the cases with junior high school education or below, the aHR of the cases with high school education or above was 0.440 (95%CI:0.238-0.810). Compared with the cases diagnosed before operation, aHR of the cases from special investigation and from counseling and testing (VCT) were 0.111 (0.027-0.456) and 0.182 (0.049-0.674) respectively. Conclusions The survival rate of HIV/AIDS cases that received ART was high in Tianjin. Risk factors related to the survival of cases would include:old age when started receiving ART, loss of follow-up during ART, diagnosed by hospitals, co-infected with hepatitis B or hepatitis C and receiving ART at Ⅲ/Ⅳ clinical stages. Meanwhile, protective factors related to the survival of cases would include:having high school or above education, diagnosis was made through other special programs or from VCT services. |
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