鄞州区艾滋病抗病毒治疗患者生存率及影响因素分析  

Survival rate and influencing factors of HIV/AIDS after highly active antiretroviral therapy in Yinzhou District

作　　者：王斌[1] 龚德光[1] 朱洁群[1] WANG Bin;GONG Deguang;ZHU Jiequn(Yinzhou Center for Disease Control and Prevention,Ningbo,Zhejiang 315100,China)

机构地区：[1]宁波市鄞州区疾病预防控制中心,浙江宁波315100

出　　处：《预防医学》2020年第4期346-350,共5页CHINA PREVENTIVE MEDICINE JOURNAL

摘　　要：目的分析宁波市鄞州区艾滋病病毒感染者和艾滋病患者(HIV/AIDS)抗病毒治疗的生存率及影响因素,为艾滋病防制提供依据。方法通过国家艾滋病综合防治信息系统收集鄞州区2005年5月—2014年12月接受高效联合抗反转录病毒治疗(HAART)的HIV/AIDS病例资料,采用寿命表法估算生存率,采用多因素Cox比例风险回归模型分析HIV/AIDS病例生存时间的影响因素。结果纳入HAART治疗HIV/AIDS病例327例,截至随访结束死亡24例,失访3例,平均随访时间为(5.63±1.98)年。治疗1年、5年和10年的累积生存率分别为95%、92%和90%。多因素Cox比例风险回归分析结果显示,开始治疗时年龄小(HR=1.053,95%CI:1.001~1.108)、异性性接触(HR=0.026,95%CI:0.003~0.253)和血液途径(HR=0.043,95%CI:0.006~0.309)感染、基线CD4+T淋巴细胞计数高(HR=0.993,95%CI:0.988~0.998)、治疗6个月后病毒载量低于检测下限(HR=0.028,95%CI:0.009~0.084)的HAART治疗HIV/AIDS病例死亡风险相对较低。结论HAART治疗HIV/AIDS病例生存率较高,开始治疗时年龄、感染途径、基线CD4+T淋巴细胞计数水平和治疗6个月后病毒载量是HAART治疗HIV/AIDS病例生存时间的影响因素。Objective To analyze the survival rate and its influencing factors of HIV/AIDS patients after antiviral therapy in Yinzhou District of Ningbo,so as to provide basis for AIDS prevention and control.Methods The data of HIV/AIDS patients who received highly active antiretroviral therapy(HAART)in Yinzhou District from May 2005 to December 2014 were retrieved from the national AIDS comprehensive prevention and control information system;the survival rate was calculated by life table and Kaplan-Meier analysis;the influencing factors for survival time was analyzed by a multivariate cox proportional risk regression model.Results Among 327 HIV/AIDS patients,twenty four were dead and three were lost.The average follow-up time was(5.63±1.98)years.The cumulative survival rates of the subjects were 95%,92%,and 90%at 1,5,and 10 years after HAART.The results of multivariate cox proportional risk regression analysis showed that patients who were at younger age when treatment begins(HR=1.053,95%CI:1.001-1.108),were transmitted by homosexual contact(HR=0.026,95%CI:0.003-0.253)and by blood transmission(HR=0.043,95%CI:0.006-0.309),had high level of CD4+T lymphocyte at baseline(HR=0.993,95%CI:0.988-0.998),and had viral load below the detection limit after six months of treatment(HR=0.028,95%CI:0.009-0.084)were less likely to be dead.Conclusions The survival rate of HIV/AIDS patients after HAART is high,and is associated with the age when treatment begins,route of transmission,baseline CD4+T lymphocyte level and viral load after six months of treatment.

关 键 词：艾滋病 抗病毒治疗 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]