2004—2020年乌鲁木齐市接受艾滋病抗病毒治疗患者生存及影响因素分析  

Analysis on survival status and influence factors of AIDS patients with antiretroviral therapy in Urumqi from 2004-2020

作　　者：李翔[1] 买吾拉尼·买买提依明[1] 崔莹莹 LI Xiang;Maiwulani·Maimaitiyiming;CUI Ying-ying(Department of AIDS Prevention,Urumqi Center for Disease Control and Prevention,Urumqi Xinjiang,830026,China)

机构地区：[1]乌鲁木齐市疾病预防控制中心艾防科,新疆乌鲁木齐830026

出　　处：《职业与健康》2022年第12期1658-1662,1665,共6页Occupation and Health

摘　　要：目的掌握乌鲁木齐市艾滋病抗病毒治疗患者的生存情况,分析影响患者死亡的危险因素。方法采用回顾性队列研究方法对2004—2020年乌鲁木齐市>14周岁且接受艾滋病抗病毒治疗的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者进行生存分析,通过寿命表法计算生存率、死亡率、累积生存率;利用Log-Rank检验进行单因素分析,采用Cox比例风险模型进行多因素分析其影响因素。结果12221例患者开始治疗时的平均年龄为(38.86±10.85)岁,平均观察时间为(63.97±42.15)个月。在观察期内有1322例(10.82%)患者死亡,因艾滋病相关疾病死亡的有565例(42.74%)。抗病毒治疗后1、2、5、10年的累积生存率分别为98.889%、97.897%、95.539%、93.245%。多因素Cox模型分析结果显示,已婚或同居的死亡风险较未婚小(HR=0.731,95%CI=0.585~0.914),以同性性传播为感染途径的患者死亡风险较低(HR=0.058,95%CI=0.024~0.142),WHO临床Ⅲ期死亡风险较高(HR=1.558,95%CI=1.243~1.952),基于拉米夫定(3TC)且含替诺福韦(TDF)的一线方案比不含的死亡风险低,开始抗病毒治疗时年龄≥50岁死亡风险较高(HR=2.017,95%CI=1.387~2.933),基线CD4细胞计数≥350个/μL死亡风险较低(HR=0.252,95%CI=0.183~0.347)。结论2004—2020年乌鲁木齐市接受艾滋病抗病毒治疗的患者累积生存率较高,其开始治疗时年龄越高、基线CD4细胞计数越低、WHO临床分期较高、初始治疗方案不含替诺福韦的HIV/AIDS患者死亡风险较高。Objective To understand the survival status of human immunodeficiency virus(HIV)infected/acquired immunodeficiency syndrome(AIDS)patients with antiretroviral therapy in Urumqi,analyze the risk factors for death of patients.Methods A retrospective cohort study was conducted on the survival analysis of HIV/AIDS patients over 14 years old receiving antiretroviral therapy in Urumqi from 2004-2020.Life table was adopted to calculate survival rate,mortality rate,and cumulative survival rate.Log-Rank test was adopted in the univariate analysis,and Cox proportional hazard model were utilized to perform the multivariate analysis on the influencing factors.Results The median age at start of treatment of 12221 patients was(38.86±10.85)years old and the median duration of follow up was(63.97±42.15)months.During the observation period,1322(10.82%)patients died,of which 565(42.74%)died from HIV/AIDS related diseases.The cumulative survival rate of the participants was 98.889%,97.897%,95.539%and 93.245%in 1,2,5,and 10 years of antiretroviral therapy respectively.Multivariate Cox proportion hazard models revealed that the participants with following characteristics were at higher mortality risk:Married or cohabiting patients had a lower risk of death than unmarried(HR=0.731,95%CI=0.585-0.914)patients infected with through homosexual transmission had a lower risk of death(HR=0.058,95%CI=0.024-0.142),patients in clinical stageⅢof WHO category had a higher risk of death(HR=1.558,95%CI=1.243-1.952),patients treated with the first-line regimen based on lamivudine(3TC)and containing tenofovir(TDF)had a lower risk of death than those without TDF,patients who were aged≥50 years at the beginning of antiviral treatment had a higher risk of death(HR=2.017,95%CI=1.387-2.933),and patients who had CD4 lymphocyte count≥350 cells/μL at the baseline checkup had a lower risk of death(HR=0.252,95%CI=0.183-0.347).Conclusion The cumulative survival rate is higher among patients with AIDS antiretroviral therapy in Urumqi from 2004-2020,and t

关 键 词：艾滋病 抗病毒治疗 生存分析 影响因素 

分 类 号：R183[医药卫生—流行病学]