成都市1992—2019年HIV/AIDS死亡率及影响因素分析  

Mortality and risk factors of HIV/AIDS cases in Chengdu from 1992 to 2019

作　　者：何世娇 施雅莹[1] 代珍[1] 范双凤[1] 何勤英[1] HE Shi-jiao;SHI Ya-ying;DAI Zhen;FAN Shuang-feng;HE Qin-ying(Department of AIDS/STD Control and Prevention,Chengdu Center for Disease Control and Prevention,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市疾病预防控制中心性病与艾滋病防制科,四川成都610041

出　　处：《现代预防医学》2021年第22期4063-4067,4084,共6页Modern Preventive Medicine

摘　　要：目的了解成都市1992—2019年HIV/AIDS死亡率及影响因素。方法采用回顾性队列研究方法,以成都市1992—2019年报告的现住址为本地的HIV/AIDS为研究对象,计算死亡率和累积生存率,运用Cox比例风险回归模型分析死亡率影响因素。结果共有41 299例HIV/AIDS纳入研究,死亡率为5.16/100人年。自2008年起死亡率逐年下降,从12.95/100人年下降至2019年的3.68/100人年。平均生存时间为15.57(95%CI:14.52~16.63)年,1、5、10和15年累积生存率分别为88.16%、79.35%、71.88%和57.42%。多因素Cox比例风险回归模型分析结果显示,女性死亡风险为男性的0.74(95%CI:0.69~0.79)倍;≥60岁组的死亡风险为<30岁组的3.20(95%CI:2.83~3.61)倍;少数民族的死亡风险为汉族的0.69(95%CI:0.54~0.88)倍;大专及以上文化程度者死亡风险为文盲的0.58(95%CI:0.50~0.67)倍;干部职员的死亡风险为农民的0.76(95%CI:0.61~0.96)倍;通过检测咨询发现者死亡风险是医疗机构发现者的0.62(95%CI:0.57~0.68)倍;同性性传播者的死亡风险是异性性传播者的0.71(95%CI:0.63~0.79)倍;首次CD4+T淋巴细胞(CD4)≥350个/μl者死亡风险为CD4<200个/μl者的0.37(95%CI:0.34~0.40)倍;未接受抗病毒治疗者的死亡风险为接受治疗者的10.36(95%CI:9.65~11.12)倍。结论成都市HIV/AIDS死亡率呈逐年下降趋势。男性、中老年、农民、文化程度较低和异性传播HIV/AIDS死亡风险较高,接受抗病毒治疗、首次CD4检测结果高、通过检测咨询发现HIV/AIDS死亡风险较低。Objective To examine the mortality and risk factors of HIV/AIDS cases in Chengdu from 1992 to 2019.Methods A retrospective cohort study was conducted to analyze the HIV/AIDS cases in Chengdu from 1992 to 2019.Mortality and cu-mulative survival rate were calculated.Cox proportional hazard regression model was used to analyze the risk factors of mor-tality.Results A total of 41 299 cases of HIV/AIDS were included in the study,with a mortality rate of 5.16/100 person years.The mortality rate decreased annually since 2008,from 12.95/100 person years to 3.68/100 person year in 2019.The mean survival time was 15.57(95%CI:14.52-16.63) years,with cumulative survival rates of 88.16%,79.35%,71.88% and57.42% at 1,5,10 and 15 years,respectively.The results of multifactorial Cox proportional risk regression model analysis showed that the risk of death for women was 0.74(95%CI:0.69-0.79) times that of men;the risk of death in the ≥60-yearold group was 3.20(95%CI:2.83-3.61) times that of the <30-year-old group;and the risk of death for ethnic minorities was0.69(95%CI:0.54-0.88) times that of Han Chinese.The risk of death among those with college education or above was 0.58(95%CI:0.50-0.67) times that of illiterate people;the risk of death among cadre employees was 0.76(95% CI:0.61-0.96)times that of farmers;the risk of death among those found through testing and counseling was 0.62(95% CI:0.57-0.68) times that of those found in medical institutions;the risk of death among same-sex sexually transmitted was 0.71(95% CI:0.63-0.79) times higher for those with heterosexual transmission;the death risk was 0.37(95% CI:0.34-0.40) times higher for those with first CD4+T lymphocytes(CD4) ≥350/μl than for those with CD4 <200/μl;the death risk was 10.36(95%CI:9.65-11.12) times higher for those not receiving antiviral treatment than for those receiving treatment.Conclusion The mortality of HIV/AIDS in Chengdu was decreasing year by year.Male,middle-aged and elderly people,farmers,people with lower education level and infected through

关 键 词：艾滋病病毒/艾滋病 死亡率 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]