文章摘要
姜雪,许佳莉,吉克春农,余刚,俞海亮,王菊,叶少东,廖强,刘中夫.凉山彝族自治州2005-2015年成年人艾滋病抗病毒治疗死亡病例流行病学分析[J].中华流行病学杂志,2019,40(9):1116-1119
凉山彝族自治州2005-2015年成年人艾滋病抗病毒治疗死亡病例流行病学分析
Epidemiological analysis of the deaths with antiretroviral treatment among adult HIV/AIDS patients in Liangshan Yi Autonomous Prefecture from 2005 to 2015
投稿时间:2019-06-05  
DOI:10.3760/cma.j.issn.0254-6450.2019.09.018
中文关键词: 艾滋病;抗病毒治疗;病死率;流行病学分析
英文关键词: AIDS;Antiretroviral therapy;Mortality rate;Epidemiological analysis
基金项目:国家自然科学基金(71774150,71573239)
作者单位E-mail
姜雪 北京市顺义区医院 101300  
许佳莉 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
吉克春农 四川省凉山彝族自治州疾病预防控制中心, 西昌 615000  
余刚 四川省凉山彝族自治州疾病预防控制中心, 西昌 615000  
俞海亮 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
王菊 四川省凉山彝族自治州疾病预防控制中心, 西昌 615000  
叶少东 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206  
廖强 四川省凉山彝族自治州疾病预防控制中心, 西昌 615000  
刘中夫 中国疾病预防控制中心性病艾滋病预防控制中心, 北京 102206 zhongfuliu@163.com 
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中文摘要:
      目的 分析四川省凉山彝族自治州(凉山州)2005-2015年成年人艾滋病抗病毒治疗死亡病例死亡情况,了解并提高凉山州艾滋病抗病毒质量,进一步降低凉山州艾滋病病死率。方法 从国家艾滋病综合防治信息系统——抗病毒治疗管理数据库收集凉山州艾滋病死亡病例相关信息进行分析。结果 凉山州2005-2015年累计接受抗病毒治疗成年人患者14 219例,其中死亡1 425例,病死率为10.02%。死亡原因以艾滋病相关疾病为主(58.9%)。病死率与性别、年龄、感染途径、抗病毒治疗时长、开始抗病毒治疗时患者所处临床分期及CD4+T淋巴细胞水平有关(P<0.001),且随着患者年龄的增加病死率增加、治疗时临床分期越高、基线CD4+T淋巴细胞水平低,病死率越高;死亡病例中男性占82.6%,已婚或同居1 182例(82.9%),死亡年龄集中在30~39岁组(48.6%),开始抗病毒治疗时CD4+T淋巴细胞<200个/μl的占49.7%;61.2%的治疗死亡病例在最后一次检测中病毒载量>1 000拷贝/ml,16.2%的治疗死亡病例在最后一次检测中CD4+T淋巴细胞≥500个/μl;44.5%的死亡病例在接受抗病毒治疗一年内死亡。结论 感染者开始接受治疗时间晚,死亡病例的治疗成功率低。应早期、及时开展抗病毒治疗,加强对抗病毒治疗患者的宣传教育,提高抗病毒治疗病例档案随访信息质量管理,有效提高服药依从性。
英文摘要:
      Objective To analyze the deaths with antiretroviral treatment among adult HIV/AIDS patients in Liangshan Yi Autonomous Prefecture from 2005 to 2015, in order to understand the epidemiological characteristics and to further reduce the mortality rate in Liangshan Prefecture. Methods The relevant information was collected through the Management Database of Antiretroviral Treatment from the National AIDS Comprehensive Prevention Information System. Results From 2005 to 2015, a total of 14 219 adult HIV/AIDS patients received antiretroviral treatment and 1 425 death cases were reported during the treatment. The cause of death was mainly AIDS-related diseases (58.9%), and the cumulative mortality rate was 10.02%. Gender, age, the way of infection, duration of antiretroviral therapy, clinical stage when received antiretroviral therapy, and CD4+ T lymphocyte levels were factors for the mortality rate (P<0.001). The mortality increased with older age, higher initiation clinical stage and lower level of CD4+ T lymphocyte. Among the death cases, 82.6% were male, 1 182 (82.9%) were married or cohabited, most aged between 30-39 years old (48.6%). At the initial point of receiving antiretroviral therapy, 49.7% of the cases with CD4+T lymphocytes levels <200/μl, 61.2% of the deaths cases were >1 000 copies/ml during the last viral load test, and 16.2% of deaths were ≥ 500/μl in the last CD4+T lymphocyte test; 44.5% of deaths were received antiretroviral treatment within one year. Conclusion Early and timely antiretroviral therapy should be carried out. It is necessary to strengthen the propaganda of antiretroviral therapy and to improve the management quality of follow-up information of antiretroviral therapy case files, and to improve the medication compliance of patients.
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