盈江县1990-2012年HIV感染者死亡率及其影响因素研究  

Study of mortality and risk factors among HIV-infected individuals during 1990-2012 in Yingjiang

作　　者：聂永英 王继娇 思志生 杨建华[1] 冯晓静[1] 李燕[1] 余顺俊 王蓉[1] 杨跃诚[2] 

机构地区：[1]云南省德宏州盈江县疾病预防控制中心性病艾滋病防治科,云南盈江679300 [2]云南省德宏州疾病预防控制中心性病艾滋病防治科,云南德宏678400

出　　处：《现代预防医学》2014年第11期2098-2102,共5页Modern Preventive Medicine

摘　　要：目的了解1990-2012年云南省德宏州盈江县HIV感染者死亡率及其影响因素。方法以盈江县1990-2012年期间报告的所有现住址为本地的HIV感染者为研究对象,收集其死亡相关信息,计算死亡率和累积生存率,并应用COX比例风险回归模型分析死亡的影响因素。结果共有3 731例HIV感染者纳入分析,其中,74.9%为男性,87.3%职业为农民,47.0%已婚有配偶,少数民族占62.7%,75.1%为文盲或小学文化程度。研究对象累计观察17 602.26人年,死亡1 513人,死亡率或死亡密度为8.60/100人年。死亡率在1990-2004年间总体呈上升趋势,自2005年起开始持续下降。研究对象平均生存时间为9.56年,其中,从未接受过抗病毒治疗者的平均生存时间为6.39年,而正在接受或曾经接受过抗病毒治疗者为17.23年。多因素分析显示,性别、民族、职业、婚姻状况、感染途径和抗病毒治疗状况等因素对HIV感染者的死亡和生存状态有显著影响。结论盈江县开展的艾滋病综合防制工作有效的降低了HIV感染者的死亡率,在将来的工作中应加强抗病毒治疗的宣传和治疗工作,扩大治疗的覆盖面。并针对HIV感染者的人口学特征有针对性的(如男性)加强管理和随访,进一步减少死亡,提高生存率。Objective To examine mortality and risk factors among HIV-infected patients during 1990-2012 in Yingjiang County, Dehong prefecture, Yunnan province. Methods All HIV-infected patients of local residents, reported during 1990-2012 in Dehong prefecture, were included in the analysis. Related information about death was collected. Mortality rates and cumulative survival rates were calculated. Multiple regression analysis using Cox proportional hazard model was conducted to examine risk factors for deaths. Results Totally, 3 731 HIV-infected patients were included for the analysis, of whom 74.9% were males, 87.3% were peasants, 47.0% were married at the time of reporting, 62.7% were ethnic minorities, and 75.1% were illiterate or only received primary school education. The patients were followed-up for a total of 17 602.26 person-years, in which 1 513 patients died, with an overall mortality rate of 8.60/100 person-years. The mortality rate had been increasing from 1990 to 2004 but decreasing since 2005. The average survival time from identification of HIV infection to the end of observation was 9.56 years overall, and was 17.23 years for those with antiretroviral treatment （ART） and 6.39 years for those without ART. Multiple regression analysis indicated that ART and sociodemographic characteristics such as gender, ethnicity, occupation, marital status and infection routes were significantly associ- ated with death among HIV-infeeted patients. Conclusion The comprehensive prevention and control activities of HIV/AIDS have effectively reduced deaths among HIV-infected patients in Yingjiang county, Dehong prefecture. More efforts on propaganda and treatment work of ART are needed while treatment coverage should be expanded in the future work. Meanwhile, management and follow-up targeting demographic characteristics of HIV infected patients such as male gender should be strengthened, to further reduce the death and improve survival rate.

关 键 词：HIV感染者 死亡率 影响因素 回顾性队列研究 

分 类 号：R195.4[医药卫生—卫生统计学]