北京市丰台区不同时期开始抗病毒治疗HIV/AIDS生存状况分析  

Survival status of HIV/AIDS patients after antiretroviral treatment initiating at different times in Fengtai District of Beijing

作　　者：李彦奇[1] 刘超[2] 尚翠 司芬芬 王欣心[1] LI Yanqi;LIU Chao;SHANG Cui;SI Fenfen;WANG Xinxin(Fengtai District Center for Disease Control and Prevention,Beijing 100071,China;Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]北京市丰台区疾病预防控制中心,北京100071 [2]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《实用预防医学》2023年第7期775-780,共6页Practical Preventive Medicine

基　　金：丰台区卫生健康系统“丰泽计划”支持项目:丰台区应用型公共卫生高级人才培养项目(2021-40558)。

摘　　要：目的 分析北京市丰台区不同时期开始抗病毒治疗HIV/AIDS的生存状况及影响因素。方法 收集艾滋病综合防治信息系统中丰台区2005-2021年开始抗病毒治疗病例数据资料,结合抗病毒治疗政策调整时间将研究对象分为2005-2007年、2008-2011年、2012-2015年、2016-2021年四组,采用生存分析方法进行回顾研究。结果 共纳入研究对象3 618例,其中2005-2007年组29例(0.80%),2008-2011年组244例(6.74%),2012-2015年组1 388例(38.36%),2016-2021年组1 957例(54.09%)。4个时期病例治疗后第1年累计生存率分别为92.98%、98.35%、98.75%、98.86%,第5年累计生存率分别为89.41%、95.33%、97.34%、98.25%,不同分组生存时间存在差异(χ^(2)=8.386,P=0.039)。多因素Cox模型分析结果显示,≥50岁开始治疗病例的死亡风险较15~29岁开始治疗病例高(HR=3.95,95%CI:1.82~8.56),基线CD4+T淋巴细胞计数<200个/μl开始治疗病例的死亡风险较基线CD4+T淋巴细胞计数≥500个/μl开始治疗病例高(HR=12.30,95%CI:2.97~50.88)。结论 随着艾滋病抗病毒治疗策略与措施的不断优化,丰台区不同时期开始治疗的病例在治疗后死亡风险逐步降低。在治疗过程中需要对开始治疗一年以内、≥50岁病例予以更多关注和支持。今后应继续推进早发现早治疗工作、不断完善抗病毒治疗,提升治疗效果。Objective To analyze the survival status and influencing factors of human immunodeficiency virus(HIV)infected/acquired immunodeficiency syndrome(AIDS)patients after antiretroviral therapy initiating at different times in Fengtai District of Beijing.Methods We collected the data about HIV/AIDS patients with antiretroviral therapy in Fengtai District during 2005-2021 from the National Integrated AIDS Prevention and Control Information System.According to the adjustment time of antiretroviral treatment policy,the subjects were divided into the treatment year group of 2005-2007,the treatment year group of 2008-2011,the treatment year group of 2012-2015,and the treatment year group of 2016-2021.A retrospective study was carried out using survival analysis method.Results A total of 3,618 cases were enrolled into this study,including 29(0.80%)cases in the treatment year group of 2005-2007,244(6.74%)cases in the treatment year group of 2008-2011,1,388(38.36%)cases in the treatment year group of 2012-2015,and 1,957(54.09%)cases in the treatment year group of 2016-2021.The one-year cumulative survival rates of the 4 treatment year groups were 92.98%,98.35%,98.75%and 98.86%respectively,and the five-year cumulative survival rates were 89.41%,95.33%,97.34%and 98.25%respectively.The differences in the survival times of patients in different treatment year groups were statistically significant(χ^(2)=8.386,P=0.039).Multivariate Cox proportion hazard models revealed that the risk of death was higher in patients initiating antiretroviral therapy at the age of≥50 years than in those initiating antiretroviral therapy at the age of 15-29 years(HR=3.95,95%CI:1.82-8.56),and the patients initiating antiretroviral therapy at CD4 lymphocyte count<200 cells/μl at the baseline had a higher risk of death than those initiating antiretroviral therapy at CD4 lymphocyte count≥500 cells/μl at the baseline(HR=12.30,95%CI:2.97-50.88).Conclusion With the continuous optimization of antiretroviral therapy strategies and measures against HIV/AID

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]