摘要
目的探讨艾滋病病毒感染者及患者（HIV/AIDS）的生存时间及其影响因素。方法采用队列研究方法,选取1999年1月1日至2013年12月31日报告的、户籍地或现住址为六安市的HIV/AIDS 66例病例作为研究对象,收集生存、诊疗、死亡等信息,以寿命表法计算生存率,以Kaplan-Meier法计算生存时间,用Cox比例风险回归模型分析生存时间影响因素。结果累计观察1502.00人年,艾滋病相关疾病的死亡率为8.06/100人年。平均生存时间9.76年（95%CI：8.98～10.53）,中位生存时间12.00年。3、5、10年累积生存率分别为80%、75%、66%。患者HIV感染途径、职业、文化程度、确诊时病期以及是否合并结核都是生存时间的影响因素。首次HIV筛查阳性时年龄越大、CD4计数水平越低,死亡风险越高;未接受高效抗反转录病毒治疗（HAART）者的死亡风险高于接受HAART者（RR=21.939,95%CI：13.002～37.019）,HAART时基线CD4计数水平越低,死亡风险越高;治疗持续时间越长,死亡风险越低（RR=27.551,95%CI：5.479～138.546）。结论扩大检测,尽早发现HIV/AIDS感染者、患者,提供规范的抗病毒治疗,预防机会性感染,是延长患者生存时间的有效手段。
Objective To understand the survival of people living with HIV /AIDS（ PLWHA） and related factors in Lu＇an,Anhui province. Methods A cohort study was conducted among the PLWHA currently living in Lu＇an and reported from 1 January 1999 to 31 December 2013. The information about their survivals,treatments,deaths and others were collected. Life table was used to calculate the survival rate and Kaplan-Meier method was used to calculate the survival time and Cox proportional hazard regression model was used to identify the factors associated with survival.Results All the PLWHA were followed up for a total of 1502. 00 person years,AIDS related mortality rate was8. 06 /100 person years. The average survival time was 9. 76 years（95% CI = 8. 98 ～ 10. 53）,the median survival time was 12. 00 years. Accumulative survival rates in 3^rd year,5^th year,10^th year were 80%,75% and 66% respectively.Transmission route,occupation,education level,clinical stage and complication of tuberculosis are the factors associated with the survival time. The PLWHA with older age at diagnosis and with lower CD4 count had higher risk of death. And the risk of death in PLWHA receiving no HAART was higher than those receiving HAART（ RR = 21. 939,95% CI：13. 002- 37. 019）. The lower the CD4 count was when HAART began,the higher the risk of death was. The longer the treatment was,the lower the risk of death was（RR = 27. 551,95% CI：5. 479- 138. 546）. Conclusion Expanding HIV detection,early finding of PLWHA,providing standard HAART and preventing opportunistic infections are effective measures to improve the survival of PLWHA.
出处
《疾病监测》
CAS
2014年第9期716-720,共5页
Disease Surveillance
