1999—2021年南京市江北新区艾滋病病例生存状况及影响因素  

The survival time and influencing factors of HIV/AIDS cases in Jiangbei New Area Nanjing

作　　者：王子培 朱有霞 高登风 WANG Zi-pei;ZHU You-xia;GAO Deng-feng(Nanjing Jiangbei New Area Public Health Service Center,Jiangsu Nanjing 210044,China)

机构地区：[1]南京市江北新区公共卫生中心,江苏南京210044

出　　处：《江苏预防医学》2022年第5期519-523,共5页Jiangsu Journal of Preventive Medicine

摘　　要：目的 分析南京市江北新区1999—2021年艾滋病病毒感染者和病人(HIV/AIDS)的生存情况及影响因素,为制定针对性防治政策提供依据。方法 利用国家艾滋病防治信息系统获取江北新区HIV/AIDS相关信息;采用回顾性队列研究方法,用寿命表法计算生存率,用Kaplan-Meier法拟合不同状态下的生存曲线,用Cox风险回归模型分析HIV/AIDS死亡的影响因素。结果 南京市江北新区1999—2021年共报告682例HIV/AIDS,全死因死亡率为2.30/100人年,平均生存时间为15.51(95%CI:14.46~16.56)年,第1、5、10、15、20年的累积生存率分别为95.47%、90.80%、76.98%、73.18%、48.78%。多因素Cox风险回归分析显示:与≥50岁年龄组比较,<30岁年龄组(HR=0.18,95%CI:0.04~0.89)和30~49岁年龄组(HR=0.54,95%CI:0.31~0.92)的HIV/AIDS死亡风险较低;与首次CD4计数<200/μl组相比,200~349/μl组(HR=0.34,95%CI:0.15~0.81)、≥350/μl组(HR=0.31,95%CI:0.15~0.61)的HIV/AIDS死亡风险较低;与未接受抗病毒治疗组相比,确诊后≤15 d启动首次抗病毒治疗组(HR=0.03,95%CI:0.01~0.13)和确诊≥16 d启动抗病毒治疗组(HR=0.04,95%CI:0.02~0.08)的死亡风险较低。结论 南京市江北新区HIV/AIDS近年全死因死亡率较低,确诊时年龄、首次CD4检测结果以及确诊后启动抗病毒治疗时间间隔是病例死亡的主要影响因素,应加强早发现和早治疗工作,提高及时治疗率。Objective To analyze survival time and influencing factors of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS) cases in Jiangbei New Area, Nanjing from 1999 to 2020. Methods The HIV/AIDS related information in Jiangbei New Area were acquired through the National AIDS Information System.The retrospective cohort study method was used, the Life table was used to calculate survival rate, the Kaplan-Meier method was used to draw the survival curve, the Cox proportional hazard regression model was used to analyze the influencing factors for deaths of HIV/AIDS cases. Results A total of 682 cases of HIV/AIDS were reported in Jiangbei New area from 1999 to 2021,the all-cause mortality rate was 2.30/100 person-years, the average survival time was(15.51±0.54) years(95%CI:14.46-16.56).The cumulative survival rates at 1,5,10,15 and 20 year were 95.47%,90.80%,76.98%,73.18% and 48.78%,respectively.The multivariate Cox proportional hazard regression model showed that compared with the age group ≥ 50 years old, the death risk of cases in the age group < 30 years old(HR=0.18,95% CI:0.04-0.89)and 30-49 years old(HR=0.54,95%CI:0.31-0.92) were lower.Compared with the first CD4 count <200/μl group, the 200-349/μl group(HR=0.34,95% CI:0.15-0.81) and ≥ 350/μl group(HR=0.31,95% CI:0.15-0.61) had lower risk of death.Compared with the group without antiviral therapy(ART),the risk of death were lower in the group that initiated the first ART within 15 days after diagnosis(HR=0.03,95% CI:0.01-0.13) and the group that initiated ART 16 days after diagnosis(HR=0.04,95% CI:0.02-0.08). Conclusion The all-cause mortality rate of HIV/AIDS cases in Jiangbei New Area is relatively low.Main influencing factors for deaths are the age at first diagnosis, first CD4 cell count, the time interval of ART after diagnosis.It’s necessary to strengthen early detection and treatment, and improve timely treatment rate.

关 键 词：人类免疫缺陷病毒感染者/艾滋病病人 生存时间 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]