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张小玲, 杨树, 付玲, 汤雪琴, 冯长华. 南昌市1994 — 2018年HIV/AIDS生存时间及其影响因素分析[J]. 中国公共卫生, 2019, 35(12): 1612-1617. DOI: 10.11847/zgggws1121149
引用本文: 张小玲, 杨树, 付玲, 汤雪琴, 冯长华. 南昌市1994 — 2018年HIV/AIDS生存时间及其影响因素分析[J]. 中国公共卫生, 2019, 35(12): 1612-1617. DOI: 10.11847/zgggws1121149
Xiao-ling ZHANG, Shu YANG, Ling FU, . Survival and its influencing factors among HIV/AIDS patients in Nanchang city, 1994 – 2018[J]. Chinese Journal of Public Health, 2019, 35(12): 1612-1617. DOI: 10.11847/zgggws1121149
Citation: Xiao-ling ZHANG, Shu YANG, Ling FU, . Survival and its influencing factors among HIV/AIDS patients in Nanchang city, 1994 – 2018[J]. Chinese Journal of Public Health, 2019, 35(12): 1612-1617. DOI: 10.11847/zgggws1121149

南昌市1994 — 2018年HIV/AIDS生存时间及其影响因素分析

Survival and its influencing factors among HIV/AIDS patients in Nanchang city, 1994 – 2018

  • 摘要:
      目的  了解江西省南昌市艾滋病病毒感染者/艾滋病(HIV/AIDS)患者生存时间及其影响因素。
      方法  运用回顾性队列研究方法,以寿命表法计算生存率,采用Kaplan-Meier绘制累积生存率曲线,Cox回归模型分析南昌市1994 — 2018年5月纳入的2 996例HIV/AIDS患者生存时间的影响因素。
      结果  2 996例HIV/AIDS患者中,914例因艾滋病及相关疾病死亡,平均死亡率为2.4/100人年;截至观察终点时,中位数生存时间为2.3年,抗病毒治疗组1、2、5、7、10年累积生存率分别为95.0 %、92.0 %、86.0 %、82.0 %、74.0 %;多因素Cox回归模型分析结果显示,≥ 60岁年龄组死亡风险是< 20岁年龄组的1.27倍(95 % CI = 1.03~1.63),男性患者死亡风险是女性的1.27倍(95 % CI = 1.03~1.56),基线CD4+T淋巴细胞计数(CD4)缺失组死亡风险是 < 200 个/mm3组的1.24倍(95 % CI = 1.02~1.50),未治疗患者死亡风险是抗病毒治疗患者10.44倍(95 % CI = 8.71~12.50)。
      结论  确诊时年龄、性别、本地出生、初诊CD4值水平、是否接受抗病毒治疗、可能感染途径等是HIV/AIDS生存时间的主要影响因素,应及早进行艾滋病检测、接受抗病毒治疗,以延长HIV/AIDS生存时间。

     

    Abstract:
      Objective  To examine the survival of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and its influencing factors in Nanchang city of Jiangxi province.
      Methods  A retrospective cohort study was conducted to analyze the data of 2 996 HIV/AIDS cases registered from 1994 through May 2018 in Nanchang city. Life table method was applied to calculate survival probability. Kaplan-Meier method was used to draw survival curve. Cox proportion hazard regression model was used to identify factors related to survival time.
      Results  Among all the patients, 914 were died of AIDS or AIDS-related diseases during the period, with a average annual mortality rate of 2.4 per 100 person-times and a median survival time of 2.3 years. The cumulated survival rate for the patients receiving antiretroviral therapy at 1, 2, 5, 7, 10-year after the confirmed HIV infection of were 95.0%, 92.0%, 86.0%, 82.0%, and 74.0%, respectively. Multivariate Cox regression analysis showed that the risk factors for death in the patients were age at the diagnosis (≥ 60 years old vs. < 20 years old: hazard ratio HR = 1.27, 95% confidence interval 95% CI: 1.03 – 1.63), gender (male vs. female: HR = 1.27, 95% CI: 1.03 – 1.56), antiretroviral treatment (no ART vs. ART: HR = 10.44, 95% CI: 8.71 – 12.50), level of baseline CD4 count (unknown vs. < 200 cell/mm 3: HR = 1.24, 95% CI: 1.02 – 1.50).
      Conclusion  Main influencing factors for survival in HIV/AIDS patients are the age at first diagnosis, gender, born in local region, CD4 count at the first detection, antiviral treatment, and route of the infection. Early detection and treatment can improve the survival of HIV/AIDS patients.

     

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