摘要
目的了解凉山州昭觉县成年获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者接受抗病毒治疗后的生存状况,并探讨其影响因素。方法采用回顾性队列研究方法,以昭觉县2005年1月1日~2017年3月20日入组参加抗病毒治疗的成年HIV/AIDS为研究对象,收集其生存死亡信息,采用生存分析方法对研究对象进行生存时间及其影响因素的分析。结果截止观察日止,2216例研究对象中仍在治疗者1528人(68.95%),因艾滋病死亡者222人(10.02%),平均生存时间为17.64月,中位生存时间13月,治疗时间少于12月者99人(44.59%)。第1~5年的累计生存率为0.93、0.90、0.88、0.86、0.85。Cox比例风险回归模型分析显示,年龄、基线CD4+T细胞计数、初始治疗方案、入组治疗时是否存在艾滋病相关疾病或症状是影响生存时间的因素(均有P<0.05)。结论昭觉县艾滋病抗病毒治疗降低了艾滋病死亡率,延长了患者的生存时间;在抗病毒治疗过程中存在多种因素影响对患者生存状况,及早发现HIV感染者并及时纳入治疗能有效提高高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)治疗成效。
Objective To explore the survival and its influencing factors among adult human immunodeficiency vi- rus/acquired immunodeficiency syndrome (HIV/AIDS) patients of highly active antiretroviral therapy (HAART) program in Zhaojue county,Liangshan prefecture. Methods A retrospective cohort study was conducted among HIV/AIDS pa- tients who received antiretroviral therapy from January 1st,2005 to March 20th,2017. Survival data of patients were col- lected. Survival time and its related factors were analyzed by survival analysis. Results Of all the patients,1 528 (68. 95%)were still under the therapy,222 (10. 02%) died of AIDS,the average survival time of them was 33. 76 months,and the median was 13 months,99(44. 59%) had the treatment duration of less than 1 year. The cumulative survival rates were 0. 93,0. 90,0. 88,0. 86,0. 85 from 2006 to 2010. Cox proportional hazard regression suggested that the survival time was associated with the age at therapy initiation,baseline CD4 + T cell count,and AIDS-related diseases or symptoms before treatment. Conclusions The national free treatment program had significantly reduced the AIDS mortality rate,prolonged the patient's survival time in Zhaojue. There were several factors that affected the patient's survival during the treatment,some effective measures should be taken to improve HAART treatment effectiveness,such as early detection of HIV/AIDS and timely treatment.
作者
孙晓蒙
马方华
赵建伟
卓玛拉措
贺亚萍
达争此吉
袁新皓
栾荣生
SUN Xiao-meng;MA Fang-hua;ZHAO Jian-wei;ZHUOMA Lacuo;He Ya-ping;DA Zheng-Ciji;YUAN Xin-hao;LUAN Rong-sheng(Department of Epidemiology and Health Statistics,West China School of Public Health,Sichuan University,Chengdu 610041,China;AIDS Antiviral Treatment Center of The People's hospital,Zhaojue 616150,China;Department of Administrative Management,School of Public Administation,Sichuan University,Chengdu 610041,China;Department of AIDS Control and Prevention,Zhaojue Center for Disease Prevention and Control,Zhaojue 616150,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2018年第12期1221-1224,1247,共5页
Chinese Journal of Disease Control & Prevention
基金
四川省昭觉县统筹城乡的艾滋病综合防控体系建设(2012GS510101)
