北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析

李洋; 王娟; 贺淑芳; 陈婧; 卢红艳

Abstract

李洋,王娟,贺淑芳,陈婧,卢红艳.北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析[J].Chinese journal of Epidemiology,2017,38(11):1509-1513

北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析

Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015

Received:April 06, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.11.014

KeyWord: 艾滋病回顾性研究生存分析相关因素

English Key Word: AIDS Retrospective studies Survival analysis Related factor

FundProject:

Author Name	Affiliation	E-mail
Li Yang	Department of AIDS/STD Control and Prevention, Beijing Municipal Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing 100013, China
Wang Juan	Department of AIDS/STD Control and Prevention, Beijing Municipal Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing 100013, China
He Shufang	Department of AIDS/STD Control and Prevention, Beijing Municipal Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing 100013, China
Chen Jing	Department of AIDS/STD Control and Prevention, Beijing Municipal Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing 100013, China
Lu Hongyan	Department of AIDS/STD Control and Prevention, Beijing Municipal Center for Disease Control and Prevention, Beijing Center for Preventive Medical Research, Beijing 100013, China	hongyan_lu@sohu.com

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Abstract:

目的分析1995-2015年北京市HIV感染者/AIDS患者（HIV/AIDS）诊断后生存时间及影响因素。方法运用回顾性队列研究方法，对1995-2015年中国艾滋病综合防治信息系统中报告的12 874例HIV/AIDS的数据资料进行分析，应用寿命表法计算生存率，采用Cox比例风险模型分析生存时间的相关因素。结果 12 874例HIV/AIDS中，303例（2.4%）死于艾滋病及相关疾病，接受抗病毒治疗9 346例（72.6%）。平均生存时间为226.5个月（95% CI：223.0~230.1），1、5、10、15年生存率分别为98.2%、96.4%、93.2%、91.9%。Cox比例风险模型分析结果显示，艾滋病死亡风险较高的因素包括诊断时为艾滋病患者（比HIV感染者，HR=1.439，95% CI：1.041~1.989）；异性传播（比同性传播，HR=1.646，95% CI：1.184~2.289）；现有或曾有配偶（比未婚，HR=2.186，95% CI：1.510~3.164）；诊断时年龄≥ 60岁（比≤ 30岁，HR=6.608，95% CI：3.546~12.316）；诊断后首次CD₄⁺T淋巴细胞计数（CD₄）<350个/μl（比≥ 350个/μl，HR=8.711，95% CI：5.757~13.181）；未抗病毒治疗（比抗病毒治疗，HR=18.223，95% CI：13.317~24.937）。结论 1995-2015年北京市HIV/AIDS诊断后的平均生存时间为226.5个月。诊断为HIV感染、同性传播、未婚、≤ 30岁、首次CD₄ ≥ 350个/μl、接受抗病毒治疗的HIV/AIDS生存时间较长。相反，诊断为AIDS、异性传播、现有或曾有配偶、年龄≥ 60岁、CD₄<350个/μl、未抗病毒治疗的死亡风险较高。

English Abstract:

Objective To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods A retrospective cohort study was conducted to analyze the data of 12 874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results Among 12 874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9 346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95% CI:223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9% respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase (HR=1.439, 95% CI:1.041-1.989), heterosexual transmission (HR=1.646, 95% CI:1.184-2.289), being married (HR=2.186, 95% CI:1.510-3.164); older age (≥ 60 years) at diagnosis (HR=6.608, 95% CI:3.546-12.316); lower CD₄⁺T cell counts at diagnosis (<350 cells/μl) (HR=8.711, 95% CI:5.757-13.181); receiving no antiretroviral therapy (ART) (HR=18.223, 95% CI:13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤ 30 years), higher CD₄⁺ T cell count (≥ 350 cell/μl) and receiving ART. Conclusion The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD₄⁺T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD₄⁺ T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.

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