1998—2023年重庆市潼南区报告HIV感染者和AIDS患者生存时间及影响因素分析  

Survival time and related factors on HIV/AIDS patients in Tongnan District,Chongqing Municipality from 1998 to 2023

作　　者：李明辉 廖杰 杨艳芳[1] LI Minghui;LIAO Jie;YANG Yanfang(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Tongnan District Center for Disease Control and Prevention,Tongnan 402660,Chongqing Municipality,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,成都610041 [2]重庆市潼南区疾病预防控制中心,重庆潼南402660

出　　处：《预防医学情报杂志》2025年第1期59-69,共11页Journal of Preventive Medicine Information

摘　　要：目的分析1998—2023年重庆市潼南区报告HIV感染者和AIDS患者生存时间与影响因素,为延长HIV感染者和AIDS患者的生存时间提供科学依据。方法利用艾滋病综合防治信息系统中1998—2023年重庆市潼南区资料,运用回顾性队列研究方法,采用R 4.2.3软件分析数据,使用寿命表描述报告HIV感染者和AIDS患者生存时间,Kaplan-Meier法估计HIV感染者和AIDS患者不同状态下的生存率和生存曲线,Cox比例风险回归模型分析HIV感染者和AIDS患者生存时间的影响因素,以P<0.05为差异有统计学意义。结果2051例HIV感染者和AIDS患者中,死亡586例(28.57%),中位生存时间为13.59年,1年、2年、3年、5年、10年和15年累计生存率分别为85.8%、80.5%、76.8%、70.3%、61.2%和49.4%。Cox比例风险回归模型分析结果显示,以诊断时年龄15~<30岁为参照组,30~<45,45~<60和≥60岁组死亡风险分别增加0.83倍(HR=1.83,95%CI:1.22~2.72)、2.10倍(HR=3.10,95%CI:2.04~4.71)和4.89倍(HR=5.89,95%CI:3.85~8.99)。以已婚有配偶为参照组,未婚组死亡风险增加0.37倍(HR=1.37,95%CI:1.04~1.82)。以农民(含民工)为参照组,家政家务及待业人员的死亡风险低21%(HR=0.79,95%CI:0.64~0.99)。以医疗机构检测发现为参照组,监管场所发现的死亡风险降低61%(HR=0.39,95%CI:0.25~0.59)。以未接受抗病毒治疗为参照组,接受抗病毒治疗的死亡风险降低85%(HR=0.15,95%CI:0.12~0.20)。以末次CD4+T淋巴细胞检测值<200个/μl为参照组,检测值200~<350个/μl、350~<500个/μl和≥500个/μl的患者死亡风险分别降低55%(HR=0.45,95%CI:0.34~0.58)、75%(HR=0.25,95%CI:0.18~0.35)和82%(HR=0.18,95%CI:0.12~0.27)。结论抗病毒治疗、末次CD4+T淋巴细胞计数、诊断时年龄等是潼南区HIV感染者和AIDS患者生存时间的主要影响因素,故对HIV感染者和AIDS患者应及早检测、诊断、接受抗病毒治疗和作好CD4+T淋巴细胞计数监测等随访管理。Objective To analyze the survival time and related factors of HIV/AIDS patients reported in Tongnan District of Chongqing from 1998 to 2023,to provide scientific basis for prolonging the survival time of HIV/AIDS patients.Methods The HIV/AIDS comprehensive prevention and control information system data from Tongnan District of Chongqing Municipality from 1998 to 2023 were used,a retrospective cohort study was conducted.R version 4.2.3 software were used to analyze the data,the survival time of HIV/AIDS patients was described by using life tables,and KaplanMeier method was employed to fit survival curves under different conditions.Additionally,Cox proportional hazards regression model was used to analyze factors influencing survival time.The difference P<0.05 was considered statistically significant.Results Out of 2051 cases of HIV/AIDS,there were 586 deaths(28.57%)and a median survival time of 13.59 years.The cumulative survival rates for the 1,2,3,5,10 and 15 years were 85.8%,80.5%,76.8%,70.3%,61.2%and 49.4%,respectively.Cox proportional hazards regression model analysis results showed that:compared to the 15~<30 age group,the risk of mortality was 0.83 times higher(HR=1.83,95%CI:1.22-2.72)for individuals aged 30~<45,2.10 times higher(HR=3.10,95%CI:2.04-4.71)for those aged 45~<60,and 4.89 times higher(HR=5.89,95%CI:3.85-8.99)for those aged 60 and above.Compared to the married counterparts,the risk of mortality was 0.37times higher(HR=1.37,95%CI:1.04-1.82)for individuals unmarried.Domestic workers and the unemployed experienced a 21%decreased mortality risk(HR=0.79,95%CI:0.64-0.99)compared to farmers.Cases detected in correctional facilities had a 61%reduced mortality risk(HR=0.39,95%CI:0.25-0.59)versus those identified in medical institutions.Patients on antiretroviral therapy exhibited an 85%lower risk of mortality(HR=0.15,95%CI:0.12-0.20)compared with those not receiving treatment.Furthermore,when last CD4~+T-cell counts were less than 200,counts of200~<350,350~<500,and 500 or higher were associated with morta

关 键 词：艾滋病病毒/艾滋病 生存时间 影响因素 

分 类 号：R512.91[医药卫生—内科学]