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陈亮, 连巧龄, 刘美增. 福建省1987 — 2018年HIV/AIDS病例生存情况及其影响因素分析[J]. 中国公共卫生, 2019, 35(12): 1623-1627. DOI: 10.11847/zgggws1123882
引用本文: 陈亮, 连巧龄, 刘美增. 福建省1987 — 2018年HIV/AIDS病例生存情况及其影响因素分析[J]. 中国公共卫生, 2019, 35(12): 1623-1627. DOI: 10.11847/zgggws1123882
Liang CHEN, Qiao-ling LIAN, Mei-zeng LIU. Survival and associated factors among HIV/AIDS patients in Fujian province, 1987 – 2018[J]. Chinese Journal of Public Health, 2019, 35(12): 1623-1627. DOI: 10.11847/zgggws1123882
Citation: Liang CHEN, Qiao-ling LIAN, Mei-zeng LIU. Survival and associated factors among HIV/AIDS patients in Fujian province, 1987 – 2018[J]. Chinese Journal of Public Health, 2019, 35(12): 1623-1627. DOI: 10.11847/zgggws1123882

福建省1987 — 2018年HIV/AIDS病例生存情况及其影响因素分析

Survival and associated factors among HIV/AIDS patients in Fujian province, 1987 – 2018

  • 摘要:
      目的  了解福建省1987 — 2018年艾滋病病毒感染者/艾滋病患者(HIV/AIDS)的生存情况及其影响因素,更好地为HIV/AIDS病例提供支持服务。
      方法  采用回顾性病例对照研究方法,对福建省1987年1月 — 2018年12月累计报告的14 973例HIV/AIDS病例进行个案流行病学调查和定期随访,计算HIV/AIDS病例的全死因死亡率、生存时间和生存率,运用Cox比例风险模型和分类回归树模型分析HIV/AIDS病例生存情况的影响因素及不同参数变量对病例生存影响的重要性,并应用ROC曲线评价模型预测效果。
      结果  截至2018年底,福建省14 973例HIV/AIDS病例中累计报告死亡病例2 537例,全死因死亡率为5.25/100人年,生存时间为210.3个月,5年生存率为80 %;Cox比例风险模型分析结果显示,报告当年疾病状态为AIDS的HIV/AIDS病例死亡风险较高,女性、年龄15~54岁、高中及以上文化程度、抗病毒治疗、最近1次CD4+T淋巴细胞计数 ≥ 200个/mm3和样本来源为重点人群、羁押人群及其他人的HIV/AIDS病例死亡风险较低;分类回归树模型分析结果显示,抗病毒治疗是HIV/AIDS病例生存状况的首要影响因素,最近1次CD4+T淋巴细胞计数、样本来源、诊断时年龄、文化程度和报告当年疾病状态的标准化重要性值依次分别为40.6、22.0、17.7、13.5和7.8,受试者工作特征曲线 (ROC)曲线下面积为0.762(95 % CI = 0.749~0.774)。
      结论  福建省1987 — 2018年HIV/AIDS病例的生存状况持续保持在相对稳定水平,早期检测和抗病毒治疗等综合干预措施可以有助于改善病例的疾病进程,减少病例的死亡和延长生存时间。

     

    Abstract:
      Objective  To analyze the status and influencing factors of survival among patients with human immunodeficiency virus infection/acquired immune deficiency syndrome (HIV/AIDS) during 1987 – 2018 in Fujian province and to provide references for implementing better medical services to the HIV/AIDS.
      Methods  We retrospectively conducted case studies and periodical follow-ups among 14 973 HIV/AIDS patients registered in the province between January 1987 and December 2018. All-cause mortality rate, time of survival and survival rate were calculated for the patients. Cox proportional hazard model and classification and regression tree model were used to explore factors related to survival of the patients HIV/AIDS and receiver operating characteristic curve (ROC) was adopted to evaluate the efficiency of established survival model.
      Results  Among all the patients, totally 2 537 deaths were reported by the end of follow-up and the all-cause mortality rate was 5.25/100 person-years; the mean survival time was 210.3 months and the 5-year cumulative survival rate was 80%. The results of Cox proportional hazard model indicated that the patients being diagnosed with AIDS at the year of registration were at a higher risk of mortality; while the patients being female, aged 15 – 54 years, with the education of senior high school and above, receiving antiretroviral therapy, with a CD4+ T lymphocyte cell count of ≥ 200 /mm3 in the latest test, classified into key groups under HIV/AIDS surveillance, being detained during the follow-up period, and being recruited in the places other than medical institutions were at a lower risk of mortality. Analysis of classification and regression tree model demonstrated antiretroviral therapy was a main impact factor for to survival status; the standardized impact importance value of CD4+ T lymphocyte cell count in the latest test, population group at the registration, age at the diagnosis of HIV/AIDS, education, and disease status at the registration were 40.6, 22.0, 17.7, 13.5, and 7.8, respectively; the area under the ROC was 0.762 (95% confidence interval: 0.749 – 0.774) for the analysis.
      Conclusion  The survival of HIV/AIDS patients in Fujian province remained at a stable level during 1987 – 2018 and early diagnosis and antiretrovival therapy could decrease mortality and prolong survival time among the patients.

     

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