北京市朝阳区老年HIV感染者和AIDS患者生存状况分析  

Survival of elderly HIV-infected/AIDS patients in Chaoyang District,Beijing

作　　者：宋亮[1] 丁海峰[1] 于淼[1] 吴玮[1] 李欣格 姜树林[1] 魏云芳[1] 吴婷婷 王丽娟[1] SONG Liang;DING Haifeng;YU Miao;WU Wei;LI Xinge;JIANG Shulin;WEI Yunfang;WU Tingting;WANG Lijuan(Chaoyang District Center for Disease Control and Prevention,Beijing 100021,China;不详)

机构地区：[1]北京市朝阳区疾病预防控制中心,北京100021 [2]香港大学家庭医学及基层医疗学系,中国香港

出　　处：《中国预防医学杂志》2024年第2期173-179,共7页Chinese Preventive Medicine

基　　金：国家科技重大专项(2018ZX10715005)。

摘　　要：目的分析北京市朝阳区老年人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者和获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者(HIV感染者/AIDS患者)的生存率及影响因素。方法通过全国“艾滋病综合防治信息管理系统”,收集1999年5月25日—2020年12月31日报告的现住址为北京市朝阳区且确诊时年龄≥50岁的HIV感染者/AIDS患者的传染病报告卡、随访调查和抗反转录病毒治疗(antiretroviral therapy,ART)等信息,采用回顾性队列分析方法分析研究对象的生存率及影响因素。结果共489例老年HIV感染者/AIDS患者纳入研究。截至2020年12月31日,死亡57例,失访53例,累计观察时间1819.96人年,观察时间中位数2.92人年。总死亡率为3.13/100人年,1、5、10、15、20年的生存率分别为91.98%、85.44%、76.53%、76.53%和76.53%。多因素Cox比例风险回归分析结果显示,与对照组相比,确诊时年龄≥70岁、性病史不详、基线CD4^(+)T淋巴细胞计数0~<200个/μl/不详/未做检测是死亡的危险因素,RR(95%CI)分别为4.72(2.35~9.49)、2.57(1.36~4.84)、6.23(1.84~21.04)。ART是保护因素,RR(95%CI)分别为0.03(0.01~0.06)(ART启动时间≤1个月)和0.07(0.03~0.14)(ART启动时间>1个月)。结论为降低老年HIV感染者/AIDS患者的病死率,延长生存时间,应加强在该人群中的HIV健康教育,扩大HIV检测,尽早发现HIV感染者/AIDS患者。Objective To analyze the survival rate of and its influencing factors among the elderly human immunodeficiency virus(HIV)-infected/acquired immunodeficiency syndrome(AIDS)patients in Chaoyang District in Beijing.Methods Cases with HIV-infection/AIDS aged 50 years and older at diagnosis reported in the period from May 25,1999 to December 31,2020 and living in Chaoyang District,Beijing were identified and relevant information were extracted from the National HIV/AIDS Information System,including their infectious disease report cards,follow-up surveys,and status of antiretroviral therapy(ART).Historical cohort analysis was used to estimate their survival rate.Cox proportional hazards model was applied to identify the factors related with survival.Results A total of 489 cases were included.As of December 31,2020,57 cases died,and 53 cases were lost to follow-up in the cohort,with a cumulative observation time of 1819.96 person-years and a median observation time of 2.92 person-years.The overall mortality rate was 3.13/100 person-years,and the survival rates at 1,5,10,15,and 20 years were 91.98%,85.44%,76.53%,76.53%,and 76.53%,respectively.Multivariable Cox proportional hazards model showed that,compared with the corresponding reference groups,aged≥70 years at diagnosis,unspecified history of sexually transmited diseases,and baseline CD4^(+)count O-<200 cells/μl,unknown,or untested were associated with increased risk of death,with relative risks(RRs)(95%CI)of 4.72(2.35-9.49),2.57(1.36-4.84),and 6.23(1.84-21.04),respectively.Receiving ART was a protective factor with RR(95%CI)being 0.03(0.01-0.06)for those who started ART no more than 1 month after diagnosis,and O.07(0.03-0.14)for those who started ART more than 1 month after diagnosis.Conclusions In order to reduce the mortality rate and prolong the survival time of elderly HIV-infected/AIDS cases,HIV health education and testing should be strengthened in this population for early detection of HIV-infected people and AIDS patients.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 老年人 生存状况 

分 类 号：R512.91[医药卫生—内科学] R183.9[医药卫生—临床医学]