济宁市1996-2023年报告的HIV/AIDS病例生存状况及影响因素分析  

Analysis on survival status and influencing factors of reported HIV/AIDS cases in Jining city from 1996 to 2023

作　　者：马希鹏 杨聪伶 孟现姣 刘梦晨 刘伟[2] MA Xi-peng;YANG Cong-ling;MENG Xian-jiao;LIU Meng-chen;LIU Wei(AIDS Prevention Department,Jining City Center for Disease Control and Prevention,Shandong 272000,China;Jining City Center for Disease Control and Prevention)

机构地区：[1]济宁市疾病预防控制中心艾滋病防制科,山东272000 [2]济宁市疾病预防控制中心

出　　处：《预防医学论坛》2024年第10期721-725,共5页Preventive Medicine Tribune

基　　金：山东省卫生健康政策研究课题(WZY202320)。

摘　　要：目的分析1996-2023年济宁市人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)病人诊断报告后的生存状况及影响因素,为制定相关防治措施提供参考。方法运用回顾性研究方法,对中国艾滋病综合防治信息系统中报告的济宁市1996-2023年HIV/AIDS病例数据资料进行分析,采用寿命表法和Kaplan-Meier法计算病例的生存率和生存时间,采用Cox比例风险模型分析生存时间的相关因素。结果1996-2023年,济宁市累计发现1920例HIV/AIDS病例,报告死亡316例,全死因病死率为8.31/100人年。平均生存时间为20.35年(95%CI:19.34~21.37),5、10年生存率分别为85%、77%。Cox比例风险模型分析结果显示,艾滋病死亡风险较高的因素包括报告时文化程度为小学及以下(HR=1.72,95%CI:1.08~2.73,P<0.05)、发现来源为医疗机构(HR=1.95,95%CI:1.42~2.68,P<0.05)、最近一次CD4^(+)T淋巴细胞计数≤350个/μL(HR=3.66,95%CI:2.77~4.84,P<0.05)、未进行抗病毒治疗(HR=25.63,95%CI:19.67~33.41,P<0.05)。结论济宁市1996-2023年HIV/AIDS病例中,文化程度较高者和检测咨询发现者死亡风险较低;通过提高抗病毒治疗覆盖面和及时性,提高CD4细胞水平可以降低死亡风险和延迟生存时间。Objective To analyze the survival status and influencing factors of human immunodeficiency virus infection/acquired immune deficiency syndrome(HIV/AIDS)in Jining city from 1996 to 2023,so as to provide references for the development of relevant control measures.Methods The HIV/AIDS cases reported in the China AIDS Comprehensive Prevention and Control Information System from 1996 to 2023 in Jining city were analyzed retrospectively.The survival rate and survival time of cases were calculated by life table method and Kaplan-Meier method,and the factors related to survival time were analyzed by Cox proportional hazard model.Results From 1996 to 2023,a total of 1920 HIV/AIDS cases were found in Jining city,and 316 deaths were reported,and the all-cause mortality rate was 8.31/100 person-year.The mean survival period was 20.35 years(95%CI:19.34-21.37),with 5-year and 10-year survival rates of 85%and 77%,respectively.Cox proportional hazards model analysis showed that the higher risk factors of AIDS death included the educational background of primary school education or below(HR=1.72,95%CI:1.08-2.73,P<0.05);being found through medical institutions(HR=1.95,95%CI:1.42-2.68,P<0.05);having a latest CD4^(+)T lymphocyte count of 350 cells/μL(HR=3.66,95%CI:2.77-4.84,P<0.05);no antiviral therapy was given(HR=25.63,95%CI:19.67-33.41,P<0.05).Conclusion In the HIV/AIDS population of Jining city from 1996 to 2023,individuals with higher educational levels and those found through testing and counseling are at a lower risk of death.Additionally,the risk of death and delayed survival can be reduced by improving antiretroviral treatment coverage and timeliness,as well as by increasing CD4 cell levels.

关 键 词：艾滋病 生存分析 回顾性队列 抗病毒治疗 影响因素 

分 类 号：R512.91[医药卫生—内科学]