甘肃省1997-2018年HIV/AIDS生存时间及影响因素分析

李健; 李慧; 余爱玲; 王斌; 王晓蕊

Abstract

李健,李慧,余爱玲,王斌,王晓蕊.甘肃省1997-2018年HIV/AIDS生存时间及影响因素分析[J].Chinese journal of Epidemiology,2019,40(11):1398-1402

甘肃省1997-2018年HIV/AIDS生存时间及影响因素分析

Survival time of HIV/AIDS cases and influencing factors in Gansu province, 1997-2018

Received:March 22, 2019

DOI：10.3760/cma.j.issn.0254-6450.2019.11.011

KeyWord: 艾滋病病毒/艾滋病生存时间影响因素

English Key Word: HIV/AIDS Survival time Influencing factor

FundProject:

Author Name	Affiliation	E-mail
Li Jian	Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
Li Hui	Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China	lihui9208@163.com
Yu Ailing	Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
Wang Bin	Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
Wang Xiaorui	Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China

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Abstract:

目的了解1997-2018年甘肃省HIV/AIDS生存时间与影响因素。方法利用国家艾滋病防治基本信息系统1997-2018年甘肃省疫情资料，采用回顾性队列研究方法，用寿命表法计算生存率，用Kaplan-Meier法绘制生存曲线并计算平均生存时间，用Cox比例风险回归模型分析HIV/AIDS的艾滋病相关死亡的影响因素。结果 6 813例HIV/AIDS中，715例（10.5%）死于艾滋病相关疾病，平均生存时间为195.9（95%CI：189.7~202.2）个月，12、60、120和180个月的累积生存率分别为91.5%、86.1%、79.9%和73.8%。Cox比例风险回归模型分析结果显示，在艾滋病相关死亡风险方面，诊断时的年龄≥ 51岁组是≤ 25岁组的1.906倍（95%CI：1.353~2.685）；其他传播途径病例是同性性传播病例的1.593倍（95%CI：1.226~2.069）；通过入院就诊、受血/血制品及术前检测发现的病例是通过出入境、婚/孕前检测及新兵体检发现病例的5.113倍（95%CI：2.083~12.547）；诊断时病程阶段为艾滋病的病例是HIV感染病例的4.012倍（95%CI：3.401~4.732）；未检测CD₄⁺T淋巴细胞（CD₄）的病例是首次CD₄值≥ 350个/μl病例的5.446倍（95%CI：3.835~7.732）；未接受抗病毒治疗的病例是已接受抗病毒治疗病例的12.019倍（95%CI：9.861~14.648）。结论 1997-2018年甘肃省HIV/AIDS平均生存时间超过16年。诊断时年龄≥ 51岁、通过入院就诊、受血/血制品及术前检测发现、诊断时病程阶段为艾滋病、未检测CD₄、未接受抗病毒治疗的HIV/AIDS死亡风险更高。应早发现、早诊断、早治疗，提高CD₄检测率及治疗率，延长HIV/AIDS的生存时间。

English Abstract:

Objective To understand the survival time and influencing factors of HIV/AIDS cases in Gansu province from 1997 to 2018. Methods A retrospective cohort study was conducted to analyze the AIDS epidemic data of Gansu from 1997 to 2018 collected from the National HIV/AIDS information system. Life-span table were used to calculate survival rate, Kaplan-Meier method was used to draw the survival curves and calculate the average survival time, the Cox proportional hazard regression model were used to analyze the risk factors for death for HIV/AIDS cases. Results Among 6 813 HIV/AIDS cases, 715 (10.5%) died, and the average survival time was 195.9 months (95%CI:189.7-202.2). The survival rates of 12 months, 60 months, 120 months and 180 months were 91.5%, 86.1%, 79.9% and 73.8%, respectively. Cox proportional hazard regression model showed that the risk factors for death in the HIV/AIDS cases were age (≥ 51 years old vs. ≤ 25 years old, HR=1.906, 95%CI:1.353-2.685), transmission route (blood borne and others transmission vs. heterosexual transmission, HR=1.593, 95%CI:1.226-2.069), detection way (hospital admission detection, blood transfusion and preoperative examination vs. entry-exit health examination, pre-marital examination and physical examination of recruits, HR=5.113, 95%CI:2.083-12.547), disease phase (AIDS phase vs. HIV infection phase:HR=4.012, 95%CI:3.401-4.732), baseline CD₄ count (no CD₄ detected vs. CD₄ count ≥ 350/μl, HR=5.446, 95%CI:3.835-7.732), antiretroviral therapy (receiving no antiretroviral therapy vs. receiving antiretroviral therapy, HR=12.019, 95%CI:9.861-14.648). Conclusions The average survival time of HIV/AIDS cases was above 16 years in Gansu during 1997 to 2018. Death risk of HIV/AIDS cases might be increased by age ≥ 51 years, hospital admission detection, blood transfusion and preoperative examination, AIDS phase of disease phase, no baseline CD₄ detected and no receiving antiretroviral therapy. It is necessary to conduct early HIV test, diagnosis and antiretroviral treatment and increase antiretroviral treatment rates and CD₄ testing rate to improve the survival of HIV/AIDS cases.

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