湖州市HIV/AIDS病人ART后生存状况及相关影响因素分析  

Survival status and influencing factors of HIV/AIDS after highly active antiretroviral therapy in Huzhou,Zhejiang province

作　　者：杨中荣[1] 李婧[1] 董正全[1] 张思潮[1] 金玫华[1] YANG Zhongrong;LI Jing;DONG Zhengquan;ZHANG Sichao;JIN Meihua(Huzhou Center for Disease Control and Prevention,Huzhou 313000,China)

机构地区：[1]湖州市疾病预防控制中心

出　　处：《中国艾滋病性病》2018年第10期997-1000,共4页Chinese Journal of Aids & STD

基　　金：湖州市科技计划项目(2017GY26);浙江省卫生高层次创新人才培养工程项目~~

摘　　要：目的了解浙江省湖州市艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)抗病毒治疗(ART)后的生存状况及相关影响因素,为科学防控艾滋病提供措施和依据。方法采用回顾性队列研究和现况调查等方法,查阅中国疾病预防控制信息系统的艾滋病防治基本信息系统中,有关HIV/AIDS病人ART后进行的随访记录以及现场流行病学问卷调查,资料录入数据库后进行相应的统计学分析。结果共调查≥16周岁接受ART的HIV/AIDS病人670例,其中男性574例(85.7%),已婚/同居345例(51.5%),平均年龄(39.90±13.42)岁。经多因素COX回归分析结果表明,在控制了患者的性别、年龄以及婚姻状况等相关潜在混杂因素之后,基线CD4+T淋巴细胞(简称CD4细胞)计数≥200个/μL组的死亡风险较基线CD4细胞计数<200个/μL组低[风险比(HR)=0.112,95%可信区间(CI):0.028~0.455],最近一个月漏服药物(次数≥2次/月)组的死亡风险较未漏服组高(HR=8.991,95%CI:2.531~31.938),具有轻度以上焦虑组的死亡风险较无焦虑组高(HR=3.673,95%CI:1.244~10.849)。结论湖州市HIV/AIDS病人免费ART后能够提高其生存率,基线CD4细胞计数高、无焦虑症及未漏服抗病毒药物会降低死亡风险,建议针对HIV/AIDS病人早期加入ART、增强其服药后的心理干预和卫生服务、以及加强服药依从性的宣教,以提高其生活质量。Objective To explore the survival status and influencing factors of HIV/AIDS patients after highly active antiretroviral therapy(HAART)in Huzhou city,Zhejiang province,so as to provide evidence for HIV/AIDS prevention and control.Methods A retrospective cohort study and field epidemiological investigation were conducted based on the records of HIV/AIDS patients after HAART,then followed by the data analysis.Results A total of 670 subjects aged 16 years old and above received HAART in Huzhou were under survey.Among them,574 were male(85.7%),and 345(51.5%)were married/cohabiting,with the average age of 39.90±13.42.The multivariate Cox regression analysis showed that after adjustment for potential confounding factors such as gender,age,and marital status of the patients,the risk of death at the baseline CD4+T lymphocyte count≥200/μL group was lower than that<200/μL group(HR=0.112,95% CI:0.028 to 0.455).The risk of death was higher in the group who had missed the drug in the last month(≥2 times/month)than those who had not missed(HR=8.991,95% CI:2.531 to 31.938).The risk of death in the group with mild and above anxiety was higher than that in the group without anxiety(HR= 3.673,95% CI:1.244 to 10.849).Conclusion The free HAART of HIV/AIDS patients in Huzhou can improve their survival time.Baseline high CD4+T-lymphocyte counts,anxiety-free and nomissed antiviral drugs will reduce the risk of death.It is recommended that HIV/AIDS patients receive HAART at an early stage.Psychological intervention and health services should be strengthened for the HIV/AIDS patients with HAART,as well as adherence to medications in order to improve their quality of life.

关 键 词：艾滋病病毒感染者/艾滋病病人 高效联合抗反转录病毒治疗 生存状况 影响因素 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]