宜昌市艾滋病患者生存时间及影响因素分析  

Analysis of Influencing factors on survival time among HIV/AIDS patients in Yichang

作　　者：倪煜欣 刘建华[2] 李芳芳 田雨[2] 闵洁 张皓[2] 王蕾[2] 赵鑫[2] 雷雯[2] Ni Yuxin;Liu Jianhua;Li Fangfang;Tian Yu;Min Jie;Zhang Hao;Wang Lei;Zhao Xin;Lei Wen(School of Public Health,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China;Department of Disease Control and Prevention,Yichang Centre for Disease Control and Prevention,Yichang 443000,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院,武汉430000 [2]宜昌市疾病预防控制中心传染病预防控制所,443000

出　　处：《国际病毒学杂志》2024年第6期492-497,共6页International Journal of Virology

摘　　要：目的分析宜昌市艾滋病病毒感染者和艾滋病患者(human immunodeficiency virus/acquiredimmune deficiency syndrome,HIV/AIDS)生存时间及其影响因素,为完善艾滋病防治策略提供依据。方法采用回顾性队列研究方法,以宜昌市1995—2019年报告的现住址为本地的HIV/AIDS为研究对象,计算死亡率和累积生存率,运用Cox比例风险回归模型分析死亡影响因素。结果共有1456例HIV/AIDS纳入研究,死亡率为3.36/100人年,1、3、5和10年的累积生存率分别为86.61%、83.38%、80.61%和74.77%。多因素Cox回归分析显示:离异或丧偶(HR=1.515,95%CI:1.150~1.997)的患者死亡风险较高,女性(HR=0.731,95%CI:0.543~0.985)、文化程度大专及以上(HR=0.367,95%CI:0.210~0.640)、确诊至开始ART的时间在14~27d内(HR=0.365,95%CI:0.128~1.044)、28~41d内(HR=0.291,95%CI:0.095~0.894)和首次CD4^(+)T细胞计数值200~349个/μL(HR=0.561,95%CI:0.381~0.826)、350~499个/μL(HR=0.507,95%CI:0.318~0.808)和≥500个/μL(HR=0.524,95%CI:0.310~0.886)者死亡风险较低。结论宜昌市HIV/AIDS患者死亡率总体较低,应针对不同的人群特征,分配适宜的干预资源,把握合适治疗时机,强化扩大检测措施的落实,提高患者生存时间。Objective To analyze the survival time and influencing factors among human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)patients in Yichang city,so as to provide evidences for the improvement of AIDS prevention and control strategies.Methods A retrospective cohort study was conducted,using local HIV/AIDS cases in Yichang from 1995 to 2019 as study subjects to calculate the mortality and cumulative survival rate.Cox proportional hazard regression model was used to analyze the risk factors of mortality.Results A total of 1456 cases of HIV/AIDS were included in the study.The mortality rate of 3.36/100 person years.The cumulative survival rates of 1,3,5,and 10-year were 86.61%,83.38%,80.61%and 74.77%,respectively.The results of multivariate Cox proportional risk regression model analysis showed that divorced or widowed people(HR=1.515,95%CI:1.150-1.997)had higher risk of death,while female(HR=0.731,95%CI:0.543-0.985),having college education or above(HR=0.367,95%CI:0.210-0.640),time from diagnosis to ART initiation within 14-27 days(HR=0.365,95%CI:0.128-1.044),within 28-41 days(HR=0.291,95%CI:0.095-0.894)and first CD4^(+)T cell count of 200-349 cells/μl(HR=0.561,95%CI:0.381-0.826),350-499 cells/μl(HR=0.507,95%CI:0.318-0.808)and≥500 cells/μl(HR=0.524,95%CI:0.310-0.886)were associated with lower risk of death.Conclusions The mortality rate of HIV/AIDS patients in Yichang city was relatively low.Appropriate intervention resources should be allocated according to different population characteristics,and the implementation of expanded testing measures should be strengthened to improve the survival time of HIV/AIDS patients.

关 键 词：艾滋病病毒/艾滋病 生存分析 影响因素 

分 类 号：R51[医药卫生—内科学]