| 曹文杰,姚永明,韦薇,林锋,鲁俊端,袁智.贵州省1995－2018年HIV/AIDS生存时间及其影响因素分析[J].中华流行病学杂志,2020,41(4):557-561 |
| 贵州省1995－2018年HIV/AIDS生存时间及其影响因素分析 |
| Survival time and related factors on HIV/AIDS patients in Guizhou province from 1995 to 2018 |
| 收稿日期:2019-06-04 出版日期:2020-04-24 |
| DOI：10.3760/cma.j.cn112338-20190604-00395 |
| 中文关键词: 艾滋病病毒/艾滋病 生存时间 死亡率 影响因素 |
| 英文关键词: HIV/AIDS Survival time Mortality Related factors |
| 基金项目:贵州省卫生和计划生育委员会科学技术基金（gzwjkj2017-1-087） |
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| 中文摘要: |
| 目的 了解1995-2018年贵州省HIV/AIDS生存时间及影响因素。方法 采用回顾性队列研究的方法,从"艾滋病防治基本信息系统"中下载1995-2018年贵州省报告的所有现住址为贵州省的HIV/AIDS报告卡。进行统计分析,运用寿命表法计算生存率、Kaplan-Meier法计算生存时间、Cox比例风险模型分析HIV/AIDS生存时间的影响因素。结果 纳入研究对象HIV/AIDS 53 232例,死亡率为8.53/100人年(14 210/166 679.18);生存时间中位数为10.20(95%CI:9.91~10.48)年,第1、5、10、20年的累积生存概率分别为0.85、0.68、0.51、0.36、0.19;多因素Cox比例风险模型分析结果显示,男性(与女性相比,aHR=0.757,95%CI:0.727~0.788)、未接受过抗病毒治疗(与接受过抗病毒治疗相比,aHR=0.173,95%CI:0.165~0.181)、首次CD4+T淋巴细胞(CD4)<200个/μl(与首次CD4 ≥ 200个/μl者相比,aHR=0.410,95%CI:0.387~0.435)、≥ 45岁 (与<45岁者相比,aHR=1.506,95%CI:1.193~1.901)、文盲(与高中及以上学历者相比,aHR=0.904,95%CI:0.832~0.982)、未婚(与离异或丧偶者相比, aHR=0.896,95%CI:0.848~0.946)、异性性传播(与同性性传播者相比,aHR=0.555,95%CI:0.487~0.632)、苗族等少数民族(与汉族相比,aHR=1.185,95%CI:1.114~1.262)、农民/民工(与家政/待业者相比, aHR=0.874,95%CI:0.834~0.916)均是影响病例生存时间的因素。结论 贵州省HIV/AIDS死亡率较高,近年来并未出现明显的下降趋势,男性、≥ 45岁、文化程度较低、少数民族、首次CD4检测<200个/μl等是影响HIV/AIDS生存时间的因素。应该针对具有这些特征的病例加强治疗和随访管理,以提高其生存质量。 |
| 英文摘要: |
| Objective To examine the survival time and related factors on HIV/AIDS patients in Guizhou province from 1995 to 2018. Methods A retrospective cohort study was conducted to analyze the HIV/AIDS case from 1995 to 2018 in Guizhou province with data gathered from the "Chinese National Comprehensive HIV/AIDS Prevention and care Information system". Survival rate was calculated by life table and survival time was estimated by Kaplan-Meier. Related factors on survival time were analyzed by Cox regression model. Results A total of 53 232 HIV/AIDS cases were included in the study, with the mortality rate as 8.53/100 person-years (14 210/166 679.18), median survival time as 10.20 (95%CI:9.91-10.48) years, and survival rates of 1, 5, 10 and 20 years as 0.85, 0.68, 0.51, 0.36, 0.19 respectively. Results from the multivariate Cox regression analysis showed that factors as:being male (compared with females, aHR=0.757, 95%CI:0.727-0.788), with antiviral treatment (ART) (compared with those without ART, aHR=0.173, 95%CI:0.165-0.181), CD4<200 cells/μl[compared with CD4+ T cells (CD4) ≥ 200 cells/μl, aHR=0.410, 95%CI:0.387-0.435], age ≥ 45 (compared with age<45, aHR=1.506, 95%CI:1.193-1.901), illiterate (compared with having high school education or above, aHR=0.904, 95%CI:0.832-0.982), unmarried (compared with divorced or widowed, aHR=0.896, 95%CI:0.848 -0.946), through heterosexual transmission (compared with homosexual transmission, aHR=0.555, 95%CI:0.487-0.632), ethnic minorities (compared with Hans, aHR=1.185, 95%CI:1.114-1.262), and farmers/migrant workers (compared with domestic/unemployed, aHR=0.874, 95%CI:0.834-0.916,) etc., were related to the survival time of HIV/AIDS, in Guizhou province. Conclusions The mortality rate of HIV/AIDS in Guizhou province appeared relatively high, but with no obvious downward trend seen in the last years. Factors as being male, age ≥ 45, low education level, ethnic minorities, CD4<200 cells/μl were identified as related to the HIV/AIDS survival time. We would suggest that treatment and follow-up management programs should be strengthened to improve the quality of life among these patients. |
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