重庆市南岸区2004-2022年经同性传播的HIV感染者/AIDS患者生存影响因素分析  

Factors influencing the survival of homosexually transmitted HIV infected/AIDS patients in Nanan District,Chongqing,China,from 2004 to 2022

作　　者：向辉 杨雯 唐小清 张睿 徐蕊 唐君为 邓雯文 吴小花[1] XIANG Hui;YANG Wen;TANG Xiaoqing;ZHANG Rui;XU Rui;Tang Jun;DENG Wenwen;WU Xiaohua(Chongqing Nan'an District Center for Disease Prevention and Control,Chongqing 401336,China)

机构地区：[1]重庆市南岸区疾病预防控制中心,重庆401336

出　　处：《中国热带医学》2023年第12期1329-1335,1357,共8页China Tropical Medicine

基　　金：重庆市卫生健康委医学科研项目(No.2023WSJK067);重庆市首批公共卫生重点学科(专科)项目(No.渝卫办发[2022]72)。

摘　　要：目的分析重庆市南岸区2004—2022年人体免疫缺陷病毒(human immunodeficiency virus,HIV)或艾滋病(acquired immunodeficiency syndrome,AIDS)经同性传播患者生存情况及其影响因素。方法选取2004―2022年重庆市南岸区经同性传播的HIV感染者/AIDS患者,采用寿命表法计算生存率,采用Kaplan Meier法计算中位生存时间并绘制生存曲线,采用Cox回归模型分析生存的影响因素。结果共纳入研究对象3110人,经同性传播1199人(38.55%),年龄主要集中在30岁以下(694人,占57.88%),婚姻状况以未婚为主(917人,占76.48%),文化程度以大专及以上为主(724人,占60.38%),民族以汉族为主(1160人,占96.75%);职业为学生人群125人(10.43%);首次诊断以HIV感染占比高(1104人,占92.08%),首次检测CD4+T淋巴细胞计数>350个/μL占71.45%,样本来源于检测咨询占52.88%,绝大多数开展抗病毒治疗。经同性传播的艾滋病患者中位生存时间为191.45个月,高于经其他途径传播的艾滋病患者,差异具有统计学意义(P<0.001)。多因素分析结果显示,在经同性传播途径中,相对CD4+T淋巴细胞计数>350个/μL的HIV感染者/AIDS患者,CD4^(+)T淋巴细胞计数水平≤200个/μL的死亡风险更高;未接受抗病毒治疗的HIV感染者/AIDS患者,死亡风险更高。结论2004—2022年重庆市南岸区HIV/AIDS报告发病水平总体呈上升趋势,2020—2022年受新冠疫情的影响,稍有下降。尚未发现经同性传播途径感染者的死亡风险显著低于其他传播途径,可能受经同性传播途径感染者确诊时间晚,随访时间较短的影响。Objective To analyze the survival status and influencing factors among HIV/AIDS transmitted through homosexual contact from 2004 to 2022 in Nan'an District,Chongqing,China.Methods HIV infected/AIDS patients transmitted through homosexual contact in Nan'an District,Chongqing from 2004 to 2022 were selected for analysis.The survival rate was calculated using the life table method,the median survival time was calculated using the Kaplan-Meier method,and the survival curve was plotted.The Cox regression model was performed to identify factors influencing survival.Results A total of 3110 subjects were included in the study,of which 1199 individuals(38.55%)were transmitted through homosexual contact.The majority of patients were under 30 years old(694,57.88%),unmarried(917,76.48%),and had a higher education level of college or above(724,60.38%),mainly belonging to the Han ethnicity(1160,96.75%).Students accounted for 10.43%of occupational status.The majority of patients were initially diagnosed with HIV(1104,92.08%),with 71.45%having a CD4^(+)T lymphocyte count>350 cells/μL at the time of initial testing.The primary source of samples was from testing and consultation(52.88%),and the vast majority(93.16%)underwent antiviral treatment.The median survival time for patients transmitted through homosexual contact was 191.45 months,which was higher than 158.37 months of patients transmitted through other routes,demonstrating statistical significance(P<0.001).Multivariate analysis showed that among patients transmitted through homosexual contact,those with CD4+T lymphocyte count≤200 cells/μL had a higher risk of death compared to those with CD4+T lymphocyte count>350 cells/μL.HIV infected/AIDS patients who did not receive antiviral treatment also had a higher risk of death.Conclusions From 2004 to 2022,the reported incidence level of HIV/AIDS in Nan'an District showed an overall upward trend,with a slight decrease influenced by respiratory infectious diseases.The risk of death for individuals infected through same-sex tr

关 键 词：人体免疫缺陷病毒 生存状况 艾滋病 同性传播 

分 类 号：R561[医药卫生—呼吸系统]