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郑武, 笪琴, 彭国平. 湖北省2006 — 2015年接受艾滋病HAART患者生存时间及影响因素[J]. 中国公共卫生, 2018, 34(2): 255-259. DOI: 10.11847/zgggws1114552
引用本文: 郑武, 笪琴, 彭国平. 湖北省2006 — 2015年接受艾滋病HAART患者生存时间及影响因素[J]. 中国公共卫生, 2018, 34(2): 255-259. DOI: 10.11847/zgggws1114552
Wu ZHENG, Qin DA, Guo-ping PENG. Time and associated factors of survival among HIV/AIDS patients with HAART in Hubei province: 2006 – 2015[J]. Chinese Journal of Public Health, 2018, 34(2): 255-259. DOI: 10.11847/zgggws1114552
Citation: Wu ZHENG, Qin DA, Guo-ping PENG. Time and associated factors of survival among HIV/AIDS patients with HAART in Hubei province: 2006 – 2015[J]. Chinese Journal of Public Health, 2018, 34(2): 255-259. DOI: 10.11847/zgggws1114552

湖北省2006 — 2015年接受艾滋病HAART患者生存时间及影响因素

Time and associated factors of survival among HIV/AIDS patients with HAART in Hubei province: 2006 – 2015

  • 摘要:
      目的   探讨湖北省艾滋病高效抗逆转录病毒治疗(HAART)患者接受治疗后的生存状况,并研究影响生存时间的因素。
      方法   回顾性分析湖北省开始接受HAART时间在2006年1月1日 — 2015年12月31日的艾滋病患者,年龄≥ 15岁,有完整的基线及随访信息。通过寿命表法计算患者的生存率、死亡率、累积生存率;通过Log-Rank检验比较不同组别间的生存时间差异并做单因素分析,采用Cox比例风险模型分析接受HAART后患者的生存时间影响因素。
      结果   共计10 065例,其中男性7 449例(74.01 %),女性2 616例(25.99 %)。在观察期内有1 048例(10.41 %)患者死亡,因艾滋病相关疾病死亡的有646例(61.64 %),治疗开始后6个月内死亡的有471例(72.91 %),治疗第1年死亡的有497例(76.93 %);累积生存率从第1年的95.03 % 下降到第10年的86.97 %;家政及服务业(HR = 1.33,95 % CI = 1.09~1.62)死亡风险大,高中/中专(HR =3.26,95 % CI = 1.72~6.18)的死亡风险较初中及以下大。基线机会性感染数越多(≥ 3个HR = 0.73,95 % CI = 0.58~0.93)、WHO临床分期越高(HR = 0.59,95 % CI = 0.49~0.70)、基线CD4+T淋巴细胞计数(≥ 351个/μL HR = 5.83,95 % CI = 1.84~18.54)、开始治疗时年龄越大(≥ 50岁HR = 0.70,95 % CI = 0.58~0.85)的艾滋病患者接受HAART后死亡风险大。
      结论   湖北省2006 — 2015年接受艾滋病HAART的患者治疗后累积生存率较高;基线机会性感染数越多、WHO临床分期越高、基线CD4+T淋巴细胞计数越低、开始治疗时年龄越大者接受HAART后生存时间短。

     

    Abstract:
      Objective   To investigate survival time and its influencing factors among human immunodeficiency virus (HIV)/AIDS patients who received highly active antiretroviral therapy (HAART) in Hubei province.
      Methods   A retrospective cohort study was carried out among HIV/AIDS patients aged 15 years and older who received HAART from January 1, 2006 to December 31, 2015 in Hubei province. Life table was adopted to calculate survival rate, mortality rate, and cumulative survival rate. Log-rank test was used to compare differences in survival time among the patients of various age groups. Univariate analysis and Cox proportional hazard model were utilized to evaluate influencing factors of survival time among the patients.
      Results   Among a total of 10 065 patients (7 449 74.01 % males, 2 616 25.99 % females) retrospectively followed-up during the 10-year period, 1 048 (10.41 %) died. Of the died cases, 646 (61.64 %) died from HIV/AIDS related diseases; 471 (72.91 %) died within the first 6 months of the treatment and 497 (76.93 %) died in the first year of treatment. For all the patients followed-up, the cumulative survival rate was 95.03 % for the first year and was 86.97 % by the end of follow-up. The patients engaged in home service industry were at a higher risk of death (hazard risk HR = 1.33, 95 % confidence interval 95 % CI: 1.09 – 1.62); the patients with the education of high school/secondary school were at a higher risk of death (HR = 3.26, 95 % CI: 1.72 – 6.18) compared to those with junior high school education or lower. Higher risks of death after receiving HAART were observed among the patients with more types of opportunistic infection at the baseline checkup (HR = 0.73, 95 % CI: 0.58 – 0.93 for having three or more types of opportunistic infection), the patients categorized as a higher clinical stage according to the criterion of World Health Organization (WHO) (HR = 0.59, 95 % CI = 0.49 – 0.70), having a CD4+T lymphocyte count of ≥ 351/μL at the baseline checkup (HR = 5.83, 95 % CI = 1.84 – 18.54), and aged ≥ 50 years when beginning HAART (HR = 0.70, 95 % CI = 0.58 – 0.85).
      Conclusion   The cumulative survival rate is relatively high and the survival is correlated positively with the number of opportunistic infection at baseline checkup, WHO clinical stage, and age of the patients and reverse with CD4+T lymphocyte count at baseline checkup among HAART treated HIV/AIDS patients in Hubei province during the period from 2006 to 2015.

     

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