摘要
目的探索艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的病死率和影响因素,以及提高抗病毒治疗(ART)效果的方法。方法采用回顾性队列研究方法。通过艾滋病综合防治信息系统,选择山西省截止到2013年12月底报告的HIV/AIDS病例和ART信息,收集资料补充调查,计算病死率和治疗比例,用Cox比例风险回归模型进行分析。结果共收集HIV/AIDS确诊病例4861例,年龄平均(36.7±13.0)岁,男性占67.9%,农民占55.0%,性传播占61.4%。从2004年到2013年ART的比例由14.9%上升到62.3%,同期HIV/AIDS病例的病死率从40.7/100人年降低到5.0/100人年。对4861例HIV/AIDS病例Cox回归分析显示,最主要死亡风险是未进行ART[危险比(HR)=4.8]和未进行CD+4T淋巴细胞检测(HR=5.9);对2400例ART病例Cox回归分析显示,治疗前体质指数(BMI)过低和肥胖病例的死亡风险高于正常和超重病例(HR=2.4)、治疗前CD+4T淋巴细胞≤50个/μL病例的死亡风险高于>50个/μL病例(HR=2.3)。结论ART显著降低了HIV/AIDS病人的病死率,提示强化ART工作可进一步降低病死率。
Objective To explore factors influence mortality rate of HIV/AIDS and to improve the effectiveness of free antiretroviral therapy（ART）.Method A retrospective cohort study was conducted in 4cities in southern Shanxi Province.Information of recipients enrolled in the national free ART program was collected and updated to Dec.2013.Mortality rate,treatment coverage were calculated and analyzed using Cox proportional hazards survival regression.Results A total of 4861 qualified cases were included in this study.The average age was 36.7±13.0,67.9% were male,55.0% were farmers,61.4% with sexually transmitted infection.Overall mortality decreased from 40.7per 100person-years in 2004 to 5.0per 100person-years in 2013,with treatment coverage concomitantly increasing from almost 14.9%to 62.3%.Cox proportional hazards survival regression was used on 4861 qualified cases which showed the strongest risk factors were not receiving antiretroviral therapy（HR=4.8）and not measure CD4 T lymphocytes（HR=5.9）.According to the Cox proportional hazards survival regression,2400 qualified cases with underweight or obese based on BMI before treatment initiation（HR=2.4）,having a CD4 count of less than 50 cells perμL before treatment initiation（HR=2.3）.Conclusion The ART has been successfully implemented with the significant decrease of HIV/AIDS related mortality rate which indicated more effectiveness could be achieved by intensifying treatment coverage.
出处
《中国艾滋病性病》
CAS
北大核心
2015年第8期676-679,共4页
Chinese Journal of Aids & STD
基金
国家科技重大专项"艾滋病和病毒性肝炎等重大传染病防治"(2012ZX10001-006)~~
