摘要
目的了解上海市接受抗病毒治疗的艾滋病病毒感染者和病人生存情况及其影响因素,评估上海市艾滋病抗病毒治疗效果。方法采用回顾性队列方法,收集上海市2005—2017年开始抗病毒治疗的艾滋病病毒感染者和病人的随访信息,随访截止时间为2018年12月31日,用寿命表法计算治疗对象的生存率,用Cox比例风险模型进行生存分析。结果9251例纳入队列的治疗对象平均年龄(38.2±13.2)岁,以男性(8447例,91.3%)和同性性传播(5536例,59.8%)为主。生存时间中位数为21.9个月,因艾滋病死亡194人,治疗1、3、5、10年的累计生存率分别为0.983、0.979、0.972、0.963。多因素Cox分析发现,年龄、基线CD4+T细胞计数、初始治疗方案、是否更换治疗方案、传播途径是治疗对象生存时间的影响因素(P<0.05)。结论上海市艾滋病抗病毒治疗效果显著,应在扩大治疗覆盖面的基础上,尽早开始抗病毒治疗,及时进行必要的治疗方案调整,改善生存质量。
Objective To investigate the survival status of people living with HIV/AIDS(PLHIV)receiving antiretroviral therapy(ART)and its influencing factors in Shanghai,and to evaluate the effect of ART.Methods A retrospective cohort study was used to analyze the follow-up data about PLHIV receiving ART in Shanghai from 2005 to 2017.The follow-up was completed on December 31,2018.Life table method was used to calculate the survival rate of PLHIV with ART,and Cox proportional hazards regression model was employed to explore associated factors of survival time.Results The average age of 9,251 PLHIV enrolled in this study was(38.2±13.2)years,and most were males(8,447 cases,91.3%)and homosexual transmission(5,536 cases,59.8%).The median survival time was 21.9 months.Deaths due to AIDS added up to 194.The accumulated survival rates of 1-,3-,5-and 10-year after initiating ART were 0.983,0.979,0.972 and 0.963,respectively.According to Cox proportional hazards regression analysis results,the factors affecting the survival time of PLHIV receiving ART were age,baseline CD4~+T-cell count,initial ART regimen,adjustment of the regimen and transmission route(all P<0.05).Conclusions The effect of ART in PLHIV in Shanghai is remarkable.ART coverage should be extended,and early ART initiation should be applied to PLHIV.Supervision of ART effect and timely adjustment of the regimen are crucial to improving survival quality of PLHIV.
作者
傅洁
岳清
庄鸣华
郑轶玲
尹鹤峰
宁镇
FU Jie;YUE Qing;ZHUANG Ming-hua;ZHENG Yi-ling;YIN He-feng;NING Zhen(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Pulmonary Hospital,Shanghai 200433,China)
出处
《实用预防医学》
CAS
2020年第11期1345-1348,共4页
Practical Preventive Medicine
关键词
艾滋病
抗病毒治疗
生存分析
影响因素
AIDS
antiretroviral therapy
survival analysis
influencing factor
