| 杨昊,王良友,乔冬菊,孟其国,王婷婷,汪剡灵,谢亚莉,王雅婷,林海江,何纳.2014-2023年浙江省台州市抗病毒治疗HIV感染者期望寿命研究[J].中华流行病学杂志,2025,46(8):1366-1371 |
| 2014-2023年浙江省台州市抗病毒治疗HIV感染者期望寿命研究 |
| Study on life expectancy among HIV-infected patients receiving antiretroviral therapy in Taizhou of Zhejiang Province, 2014 to 2023 |
| 收稿日期:2025-04-05 出版日期:2025-08-21 |
| DOI：10.3760/cma.j.cn112338-20250405-00214 |
| 中文关键词: HIV感染者 抗病毒治疗 期望寿命 |
| 英文关键词: HIV-infected patients Antiretroviral therapy Life expectancy |
| 基金项目:国家重点研发计划（2022YFC2304902）；台州市高层次人才特殊支持计划（TZ2022-2）；上海市加强公共卫生体系建设行动计划重点学科建设项目（GWVI-11.1-05） |
| 作者 | 单位 | E-mail | | 杨昊 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | | | 王良友 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 乔冬菊 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 孟其国 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 王婷婷 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 汪剡灵 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 谢亚莉 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 王雅婷 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 林海江 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | fudanlhj@qq.com | | 何纳 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | nhe@fudan.edu.cn |
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| 中文摘要: |
| 目的 探究2014-2023年浙江省台州市抗病毒治疗HIV感染者的期望寿命及其变化趋势。方法 资料来源于中国疾病预防控制信息系统，研究对象为在台州市接受抗病毒治疗的HIV感染者。基于蒋庆琅法编制简略寿命表，分析2023年不同特征台州市接受抗病毒治疗HIV感染者期望寿命的差异，并比较2014-2023年启动抗病毒治疗时不同CD4+T淋巴细胞（CD4）计数HIV感染者期望寿命变化趋势。结果 本研究共纳入4 825例HIV感染者，累计随访276 648.56人年，病死率为18.07（95%CI：16.48~19.65）/1 000人年。2023年，各年龄段男性HIV感染者期望寿命低于女性，已婚HIV感染者期望寿命高于未婚和离异/丧偶HIV感染者；异性性传播HIV感染者期望寿命低于同性性传播HIV感染者；各年龄段启动抗病毒治疗时CD4计数≥350个/μl的HIV感染者的期望寿命均高于CD4计数<200个/μl的HIV感染者。抗病毒治疗HIV感染者20、50岁时期望寿命分别由2014年的39.0、19.1年增长至2023年的46.0、24.1年，平均年变化百分比分别为2.43%（95%CI：0.81%~4.07%）、3.34%（95%CI：1.17%~5.56%）。2016-2023年启动抗病毒治疗时CD4计数≥350个/μl与200~个/μl的HIV感染者期望寿命变化情况相似，均高于<200个/μl的HIV感染者。各CD4计数下，HIV感染者50岁时期望寿命增长速度均高于20岁时期望寿命。结论 台州市抗病毒治疗HIV感染者的期望寿命增长趋势明显，但不同特征HIV感染者间差距明显，特别是启动抗病毒治疗时CD4计数<200个/μl的HIV感染者，提示扩大检测、早期诊断和及时启动抗病毒治疗对提高HIV感染者期望寿命的重要性。 |
| 英文摘要: |
| Objective To investigate the life expectancy of antiretroviral treatment (ART) HIV-infected patients and its trends in Taizhou City, Zhejiang Province from 2014 to 2023. Methods The data were obtained from the China Information System for Disease Control and Prevention, and the study subjects were HIV-infected patients received ART in Taizhou City. An abbreviated life expectancy table was prepared based on Chiang's method to analyze the differences in life expectancy of HIV-infected patients receiving ART in Taizhou City with different characteristics in 2023 and to compare the trends in life expectancy of patients with different CD4+T lymphocytes (CD4) counts at the time of initiation of ART from 2014 to 2023. Results A total of 4 825 patients were enrolled in this study, with a cumulative follow-up of 276 648.56 person-years, and a case-fatality rate of 18.07 (95%CI: 16.48-19.65) /1 000 person-years. In 2023, male patients had lower life expectancy than females in all age groups, and those who were married had higher life expectancy than those who were unmarried and those who were divorced or widowed; patients who had been transmitted heterosexually had lower life expectancy than those who had been transmitted through homosexual transmission. Patients with different CD4 counts at the time of initiating ART had different life expectancies in all age groups. The life expectancy of patients with CD4 counts ≥350 cells/μl when initiating the treatment was higher than that of patients with CD4 counts <200 cells/μl in all age groups. The life expectancy of HIV-infected patients on ART at age 20 and 50 increased from 39.0 years and 19.1 years in 2014 to 46.0 years and 24.1 years in 2023, respectively, with an average annual percentage change of 2.43% (95%CI: 0.81%-4.07%) and 3.34% (95%CI: 1.17%-5.56%). The change in life expectancy was similar for patients with CD4 counts ≥350 cells/μl and 200-349 cells/μl at the time of initiating treatment in 2016-2023, and was higher than that for patients with CD4 counts <200 cells/μl. The rate of increase in life expectancy for patients at age 50 was higher than that at age 20 for all CD4 counts. Conclusions The rising trend of life expectancy among HIV-infected patients on ART in Taizhou City is obvious. But the disparity between patients with different characteristics is obvious, especially among patients with baseline CD4 counts <200 cells/μl, suggesting the importance of expanded testing, early diagnosis and timely initiation of ART to improve the life expectancy of HIV-infected patients. |
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