玉溪市HIV/AIDS病人静脉注射吸毒死亡者中死于吸毒过量的情况及相关因素  

State and factors associated with overdose-caused mortality among HIV/AIDS patients who were injecting drug user in Yuxi,1995-2017

作　　者：董文斌[1] 李世福[1] 赵金仙[1] 赵秋芳 蔡英[1] 陈黎跃[1] 李顺祥[1] 吴强[1] 鲁建波[1] DONG Wenbin;LI Shifu;ZHAO Jinxian;ZHAO Qiufang;CAI Ying;CHEN Liyue;LI Shunxiang WU Qiang;LU Jianbo(Yuxi Centre for Disease Control and Prevention,Yuxi 653100,Yunnan,China)

机构地区：[1]云南省玉溪市疾病预防控制中心

出　　处：《中国艾滋病性病》2019年第10期1052-1055,1076,共5页Chinese Journal of Aids & STD

摘　　要：目的探讨玉溪市静脉注射吸毒传播的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)死亡者中死于吸毒过量的情况及其相关因素。方法收集玉溪市1995-2017年HIV/AIDS病人静脉注射吸毒死亡者的死因及相关信息,采用CoDe编码系统归类,应用二分类Logistic回归分析。结果静脉注射吸毒传播的HIV/AIDS病人死亡404例,死亡时年龄中位数M=36(IQR:32~40)岁。死因以吸毒过量(32.43%,131例)居首,其次是机会性感染(31.68%,128例)。总体平均生存时间(4.96±4.30)年,死于心肺功能衰竭(2.59±3.65)年、自杀(3.27±2.43)年的平均生存时间最短。年龄15~29岁、未婚、最近一次CD4细胞计数>500个/μL、没有抗病毒治疗(ART)、死亡时病程为AIDS死于吸毒过量率较高,经多因素Logistic回归分析发现:年龄为40~49岁[比值比(OR):0.299,95%可信区间(CI):0.108~0.828]不容易死于吸毒过量;最近一次CD4+T淋巴细胞(简称CD4细胞)计数>500个/μL(OR:2.594,95%CI:1.224~5.496)、病程为AIDS(OR:7.130,95%CI:3.575~14.221)更容易死于吸毒过量。结论HIV/AIDS病人静脉注射吸毒死亡者中死于吸毒过量与年龄、最近一次CD4细胞值以及死亡时的病程有关,针对具有较高吸毒过量死亡风险的人员,给予特别关注和心理支持,加强其吸毒过量方面的教育,减少HIV/AIDS病人注射吸毒者的死亡。Objective To examine the overdose-caused mortality and its influencing factors among patients with acquired immune deficiency syndrome/human immunodeficiency virus(HIV/AIDS)transmitted through injecting drug use.Methods Data of HIV/AIDS patients dead between 1999 and 2017 and with the registered permanent residence in Yuxi municipality of Yunnan province were extracted from the National Comprehensive Information System for AIDS Control and Pre vention.The specific causes of the HIV/AIDS deaths were classified based on the Coding Causes of Death in HIV(CoDe)Project.Multivariate logistic regression was used to analyze the factors associated with the deaths.Results Of the 404 deaths identified,the median age at death was 36(IQR:32-40)years old.131(32.43%)died from drug overdose and others from opportunistic infections(31.68%,128/404).The mean survival time was 4.96±4.30 years,and the mean survival time of cardiopulmonary failure(2.59±3.65 years)and suicide(3.27±2.43 years)was the shortest among causes of the HIV/AIDS deaths.Cases with following characteristics accounted for higher rate of drug overdose,including those at the age of 15-29 years old,unmarried,CD4 cell count>500/μL,and no antiviral therapy.Multivariate logistic regression analysis indicated that the patients aged 40-49 years(OR:0.299,95%CI:0.108-0.828,compared to those aged 15-29 years)were not likely to die from drug overdose.Those with CD4^+T cell count>500 cell/μL at the last detection(OR:2.594,95%confidence interval[95%CI]:1.224-5.496),and those at the disease stage of AIDS(OR:7.130,95%CI:3.575-14.221)were more likely to die from drug overdoses.Conclusion The age,CD4^+T cell count at the last detection,disease progress of AIDS are associated with overdose-caused mortality among HIV/AIDS patients who are injecting drug users.To reduce the overdose-caused mortality,specific intervention measures,and psychological support should be given to those with higher risks of death by drug overdose.

关 键 词：艾滋病病毒感染者/艾滋病病人 静脉注射吸毒 吸毒过量 影响因素 

分 类 号：R512.91[医药卫生—内科学]