1996-2022年鄂州市HIV/AIDS病例生存状况及相关影响因素分析  

The living condition and influencing factors of HIV/AIDS cases in Ezhou City from 1996 to 2022

作　　者：李琼燕[1] 熊玮[1] 秦艺[1] 蔡文莲 陈敬义[1] LI Qiongyan;XIONG Wei;QIN Yi;CAI Wenlian;CHEN Jingyi(Ezhou Center for Disease Control and Prevention,Ezhou 436000,Hubei Province,China;Ezhou Maternal and Child Health Hospital,Ezhou 436000,Hubei Province,China)

机构地区：[1]鄂州市疾病预防控制中心,湖北鄂州436000 [2]鄂州市妇幼保健院,湖北鄂州436000

出　　处：《预防医学情报杂志》2023年第9期1072-1077,共6页Journal of Preventive Medicine Information

摘　　要：目的 了解1996-2022年鄂州市报告的艾滋病病毒感染者/病人(HIV/AIDS)生存状况及相关影响因素。方法 收集1996-2022年鄂州市报告的所有HIV/AIDS信息,采用回顾性队列研究方法,用寿命表法计算生存率,用独立样本t检验比较是否接受高效抗逆转录病毒治疗(HAART)的生存期差异,利用Kaplan-Meier法计算各组生存均值,采用Cox比例风险模型分析影响死亡的主要危险因素。结果 1996-2022年,鄂州市共报告HIV/AIDS 573例(剔除母婴传播6例),累计死亡(全死因)139例,其中69例从未接受过HAART死亡者中位生存时间为4.95个月,70例接受过HAART后死亡者中位生存时间为27.29个月。573例HIV/AIDS,中位生存时间为19.00年,HIV/AIDS确证后1、5、10和15年的生存率分别为84%、75%、67%和63%。Kaplan-Meier分析显示,确证时年龄、初始CD4+T淋巴细胞计数、教育程度、是否接受HAART及病程阶段与病例的生存时间均相关,Cox比例风险模型分析显示,60岁以上者死亡风险是20岁以下者的2.059倍;初始CD4^(+)T淋巴细胞计数>200个/mm3及>500个/mm^(3)者的死亡风险分别是<200个/mm^(3)者的0.351及0.133倍;未接受HAART者的死亡风险是接受HAART者的12.277倍。结论 HAART可以有效延长HIV/AIDS的生存时间;确证时年龄低于20岁以及初始CD4+T淋巴细胞计数>500个/mm3者的死亡风险相对较低,应加大潜在HIV/AIDS的发现力度,尽早开展HAART,降低死亡风险。Objective To investigate the survival status and influencing factors of HIV/AIDS infections and patients reported in Ezhou city from 1996 to 2022.Methods The reported HIV/AIDS cases information in Ezhou city from 1996 to 2022 was collected.A retrospective cohort study was conducted.The survival rate was calculated by life-table method.The difference of survival time of whether received Highly Active Anti-Retroviral Therapy(HAART)was compared by Independent samples t-test.A Kaplan-Meier method was adopted to calculate the median survival time in each group,while a Cox proportional hazard model was used to analyse the major risk factors affecting longevity.Results A total of 573 cases of HIV/AIDS were reported in Ezhou city from 1996 to2022(excluding 6 cases infected via mother-to-fetus transmission).The cumulative number of death(all-causes)was 139.Among these death cases,the median survival time of the 69 cases that never received HAART was 4.95 months;While that of the 70 cases that received HAART was27.29 months.Among the 573 HIV/AIDS cases,the median survival time was 19.00 years,and the survival rates of 1,5,10 and 15 years after HIV/AIDS diagnosis were 84%,75%,67%and63%,respectively.Kaplan-Meier analysis showed that the age at diagnosis,the initial CD4+T lymphocyte count,education level,whether accepted HAART statusand the stage of disease progression,those were all related to the survival time.Analysis of Cox proportional hazard model showed that:the risk of death for people over 60 years old was 2.059 times that of those under 20 years old;The death risk of those with the initial CD4+T lymphocyte count 200/mm3and 500/mm3was 0.351 and 0.133 times that of those 200/mm3,respectively.The risk of death for those who did not received HAART was 12.277 times higher than those who received HAART.Conclusions HARRT can effectively prolong the survival time of HIV/AIDS.The death risk is relatively lower for patients with the age at diagnosis under 20 and initial CD4+T lymphocyte count 500/mm3.It is necessary to promot

关 键 词：人类免疫缺陷病毒 全死因死亡率 生存分析 Cox比例风险模型分析 

分 类 号：R512.91[医药卫生—内科学]