摘要
目的比较河南省不同时期接受抗病毒治疗(ART)艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的生存状况。方法采用回顾性研究,对河南省2003年1月至2015年12月接受ART治疗且≥16岁HIV/AIDS病人的生存状况进行分析,采用SPSS23.0软件统计分析,寿命表法计算不同ART时期艾滋病病人的死亡率和生存率,Log-Rank法比较不同时期病人生存状况的差异,建立COX比例风险回归模型分析不同ART时期病人的死亡风险。结果共有40932例病例纳入分析,其中男性23986例(58.6%),女性16946例(41.4%);年龄<40岁占16.21%,40~60岁占62.27%,>60岁占21.52%;职业以农民为主,占77.58%;传播途径以血液传播为主,占62.68%,其次为性传播,占30.20%;初始ART方案:十五期间(2003-2005年)司坦夫定(D4T)/齐多夫定(AZT)+去羟肌苷(DDI)+奈韦拉平(NVP)/依非韦仑(EFV)方案为主,占95.1%,十一五期间(2006—2010年)D4T/AZT+拉米夫定(3TC)+NVP/EFV方案为主,占68.5%,十二五期间(2011-2015年)替诺福韦(TDF)/AZT+3TC+/EFV/NVP方案为主,占90.04%。十五、十一五、十二五期间艾滋病病人的死亡率分别为7.91/100人年、5.19/100人年和2.66/100人年,1年累计生存率分别为0.89、0.92、0.96,3年累计生存率分别为0.84、0.84、0.93,十一五和十二五期间5年累计生存率为0.79和0.89,不同ART时期病人的生存状况有统计学差异(χ^2=454.02,P<0.05)。十五、十一五期间病人死亡风险分别是十二五期间的2.649(2.335~3.006)倍和2.155(2.010~2.311)倍。结论随着艾滋病防治工作的开展,HIV/AIDS病人的死亡率和死亡风险降低、生存率提高,生存时间延长,免费抗病毒治疗取得显著成效。
Objective To analyze the survival conditions of HIV/AIDS patients in different antiretroviral therapy(ART)period in Henan province.Methods A retrospective cohort study was made among HIV/AIDS patients≥16 years old with ART from Jan 2003 to Dec 2015 in the province.Statistical analysis was conducted by SPSS23.0.The lifetime table was used to calculate the cumulative survival rate of each group and the Log-Rank for difference comparison of the survival time of HIV/AIDS patients in each period.The Cox proportional risk model predicted the mortality risk of patients at different ART stages.Results A total of 40 932 cases were included in the study,with 23 986(58.6%)males and 16 946 females(41.4%),16.21%aged<40 years,62.27%aged between 40-60 years,and 21.52% aged >60 years.77.58% were farmers.The main transmission route was through blood(62.68%),followed by sexual transmission(30.20%).The main ART regimen was D4 T/AZT+DDI+NVP/EFV(95.1%)during 2003-2005,D4 T/AZT+3 TC+NVP/EFV(68.5%)during 2006-2010,and TDF/AZT+3 TC+/EFV/NVP(90.04%)during 2011-2015.The death rate of HIV patients were 7.91/100,5.19/100 and 2.66/100 per year during 2003-2005,2006-2010 and 2011-2015 respectively.The one-year cumulative survival rate were0.89,0.92,and 0.96,and three-year cumulative survival rates were 0.84,0.84,and 0.93.The fiveyear cumulative survival rates were 0.79 and 0.89 during 2003-2005,and 2006-2010.The survival rates of patients in different ART period were statistically significant(χ~2=454.02,P<0.05).Compared to that in the period of 2011-2015,the mortality risk were 2.649(2.335-3.006)times and 2.155(2.010-2.311)times in the periods of 2003-2005 and 2006-2010.Conclusion With the development of AIDS prevention and treatment,the survival time of HIV/AIDS patients is getting longer,and the mortality risk rate is lower,indicating antiviral therapy has achieved significant results.
作者
陈昭云
孙燕
赵清霞
张雪
CHEN Zhaoyun;SUN Yan;ZHAO Qingxia;ZHANG Xue(Henan Provincial Infectious Diseases Hospital,Zhengzhou Sixth People's Hospital,Zhengzhou 450015,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2018年第12期1200-1204,共5页
Chinese Journal of Aids & STD
基金
河南省科技攻关计划项目支持(162102310217)~~
