| 张金瑞,陈清峰,汤后林,许宏霞,陈方方.黑龙江省佳木斯市2010-2020年HIV/AIDS确证后死亡密度特征分析[J].中华流行病学杂志,2022,43(12):1920-1924 |
| 黑龙江省佳木斯市2010-2020年HIV/AIDS确证后死亡密度特征分析 |
| Characteristics of mortality density of HIV/AIDS cases after diagnosis in Jiamusi of Heilongjiang province, 2010-2020 |
| 收稿日期:2022-08-23 出版日期:2022-12-17 |
| DOI：10.3760/cma.j.cn112338-20220823-00727 |
| 中文关键词: 艾滋病病毒 艾滋病 死亡密度 回顾性队列 |
| 英文关键词: HIV AIDS Mortality density Retrospective cohort |
| 基金项目:中国现场流行病学培训项目（131031001000200011）；中国疾病预防控制中心性病艾滋病预防控制中心青年科研基金（2018AFQN003） |
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| 中文摘要: |
| 目的 分析黑龙江省佳木斯市HIV/AIDS确证后死亡密度特征及影响因素。方法 资料来源于中国疾病预防控制信息系统艾滋病综合防治信息系统，选取现住址为佳木斯市、确证时间为2010-2020年和确证年龄≥15岁的HIV/AIDS作为研究对象。采用回顾性队列研究方法，收集基线和随访信息，描述其确证后的死亡密度特征。确证后死亡定义分为确证后1~、7~和≥13个月死亡，采用多因素Cox比例风险回归模型分析确证后1~6个月死亡密度的影响因素。采用Excel 2019和SPSS 22.0软件进行数据整理和统计学分析。结果 共953例HIV/AIDS，死亡173例，以男性（89.19%，850/953）、未婚/离异/丧偶（76.50%，729/953）、初中及以下文化程度（51.84%，494/953）和同性性传播为主（77.02%，734/953）。累计随访3 944.59人年，死亡密度为4.39（95%CI：3.79~5.07）/100人年。确证后1~6个月的HIV/AIDS死亡密度最高，为21.60（95%CI：18.04~25.86）/100人年，确证后≥13个月降至2.02（95%CI：1.59~2.58）/100人年。在确证后1~6个月死亡的HIV/AIDS中，首次CD4+T淋巴细胞（CD4）未检测（51.61%，48/93）和艾滋病相关死亡的比例（32.26%，30/93）较高。多因素Cox比例风险回归模型分析结果显示，确证后1~6个月死亡的风险因素包括确证年龄较大、医疗机构检测发现、首次CD4计数<200个/μl或CD4未检测和未抗病毒治疗。结论 2010-2020年佳木斯市HIV/AIDS的死亡密度整体水平较低，随着确证后生存时间的延长呈下降趋势。应继续加强早诊断和早治疗，重点关注确证后1~6个月HIV/AIDS的随访管理，进一步降低确证后的死亡风险。 |
| 英文摘要: |
| Objective To analyze characteristics of mortality density and the influencing factors of HIV/AIDS after diagnosis in Jiamusi of Heilongjiang province. Methods The data were retrieved from HIV/AIDS Comprehensive Response Information System and selected cases diagnosed with HIV/AIDS in Jiamusi of Heilongjiang province during 2010-2020 and aged 15 years or older as the study objects. The method of retrospective cohort study was used to collect baseline and follow-up information, and characteristics of mortality density after HIV diagnosis were described. Death after HIV diagnosis was divided into 1-6 months, 7-12 months, and ≥13 months after HIV diagnosis. The Cox proportional hazards model was used to analyze the associated factors of mortality density within six months after HIV diagnosis. Excel 2019 and SPSS 22.0 software were used for data processing and statistical analysis. Results A total of 953 HIV/AIDS with 173 deaths were included during the study period. Most HIV/AIDS were men (89.19%, 850/953), single or divorced or widowed (76.50%, 729/953), educated in middle school and lower level (51.84%, 494/953), and men who have sex with men (77.02%, 734/953). There was a cumulative follow-up of 3 944.59 person-years, with an overall mortality density of 4.39 (95%CI: 3.79-5.07)/100 person- years. The mortality density was highest in 21.60 (95%CI: 18.04-25.86) 100 person-years within the first six months after diagnosis, then decreased to 2.02 (95%CI: 1.59-2.58)/100 person-years over 13 months or more after HIV diagnosis. HIV/AIDS who died within the first six months after diagnosis had a higher proportion of first CD4+T lymphocytes (CD4) counts untested (51.61%, 48/93) and AIDS-related deaths (32.26%, 30/93). In the multivariate analysis of the Cox proportional hazards regression model, mortality density within the first six months after HIV diagnosis was greater among HIV/AIDS who were older at diagnosis, detected by medical institutions, with lower first CD4 counts or no testing, and never receiving antiretroviral therapy (ART). Conclusions Mortality density was generally low in Jiamusi of Heilongjiang province during 2010-2020 and declined over the follow-up time. However, early diagnosis and immediate ART initiation should be strengthened. Attention should also be paid to follow-up care management and referral services for HIV/AIDS within the first six months after HIV diagnosis to reduce the risk of death after HIV diagnosis. |
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