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周信娟, 沈智勇, 阮玉华, 孟琴, 刘玄华, 吴秀玲, 黄精华, 朱秋映. 经母婴传播艾滋病患者生存分析[J]. 中国公共卫生, 2018, 34(7): 960-963. DOI: 10.11847/zgggws1116201
引用本文: 周信娟, 沈智勇, 阮玉华, 孟琴, 刘玄华, 吴秀玲, 黄精华, 朱秋映. 经母婴传播艾滋病患者生存分析[J]. 中国公共卫生, 2018, 34(7): 960-963. DOI: 10.11847/zgggws1116201
Xin-juan ZHOU, Zhi-yong SHEN, Yu-hua RUAN, . Survival of HIV/AIDS patients infected via mother to child transmission[J]. Chinese Journal of Public Health, 2018, 34(7): 960-963. DOI: 10.11847/zgggws1116201
Citation: Xin-juan ZHOU, Zhi-yong SHEN, Yu-hua RUAN, . Survival of HIV/AIDS patients infected via mother to child transmission[J]. Chinese Journal of Public Health, 2018, 34(7): 960-963. DOI: 10.11847/zgggws1116201

经母婴传播艾滋病患者生存分析

Survival of HIV/AIDS patients infected via mother to child transmission

  • 摘要:
      目的  了解广西壮族自治区经母婴传播感染艾滋病的患者生存状况及其影响因素。
      方法  利用中国疾病预防控制系统艾滋病综合防治信息系统数据,采取回顾性队列研究方法,对2001 — 2015年报告的传播途径为母婴传播或接触史有母亲艾滋病病毒(HIV)抗体阳性、且现住址在广西壮族自治区的艾滋病患者进行分析,用Kaplan-Meler绘制生存曲线,Cox比例风险模型分析其影响因素。
      结果  共纳入研究对象940例,中位观察时间为2.39人年,死亡207例,死亡率为7.79/100人年。经Cox比例风险回归模型分析,首次CD4细胞计数、报告来源、治疗情况与研究对象死亡有统计学关联。经控制混杂因素后,首次CD4细胞计数为500~351 个/μL、350~200 个/μL、< 200 个/μL的死亡风险是 > 500 个/μL的1.72倍、2.64倍和3.74倍;来源于医院就诊检测的死亡风险是检测咨询的2.13倍;未接受抗病毒治疗的死亡风险是接受抗病毒治疗的12.62倍,2者的生存率曲线分布有统计学意义(χ2 = 386.705,P < 0.001)。
      结论  广西壮族自治区经母婴传播艾滋病患者早发现早治疗尚存在较大空间,首次CD4细胞计数、报告来源和治疗情况是影响生存时间的主要因素。

     

    Abstract:
      Objective  To examine the survival and its related factors among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients infected via mother to child transmission in Guangxi Zhuang Autonomous Region (Guangxi).
      Methods  We collected data on 940 HIV/AIDS patients from Chinese National HIV/AIDS Comprehensive Control and Prevention Information System for a retrospective cohort study. The participants of the study were permanent residents of Guangxi and registered between 2001 through 2015; HIV infection via mother to child transmission or maternal HIV positive was confirmed among all the participants. The survival curve was estimated using Kaplan-Meier method and influencing factors for the survival was analyzed with Cox proportional hazard regression.
      Results  The median observation time was 2.39 years. Totally 207 cases died during the follow-up and the mortality rate was 7.79/100 person years. The Cox proportional hazard analyses revealed that initial CD4 cell count, source of registration information, and therapeutic status were correlated with the survival of the patients; after adjusting for confounding factors, the death risk were higher among the patients with lower initial CD4 cell count (hazard risk HR = 1.72, 2.64, and 3.74 for the participants with the initial CD4 count of 500 – 351, 350 – 200, and < 200 cells/μL compared to those with the count of > 500 cells/μL), being diagnosed as HIV positive in hospitals (HR = 2.13 compared to those diagnosed in voluntary counseling and testing), and without antiviral therapy (HR = 12.62 compared to those with antiviral therapy). The survival curves for the patients with and without antiviral therapy were significantly different (χ2 = 386.705, P < 0.001).
      Conclusion  Early diagnosis and treatment need to be greatly improved for HIV/AIDS patients infected via mother to child transmission in Guangxi and the survival of the patients is mainly influenced by initial CD4 cell count, source of registration information, and therapeutic status.

     

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