摘要
目的分析河南省抗病毒治疗(ART)≥15岁HIV/AIDS的死亡状况,为降低HIV/AIDS病死率提供参考依据。方法资料来源于艾滋病综合防治信息系统2002-2019年河南省开始ART≥15岁HIV/AIDS,采用回顾性队列研究方法,应用Cox比例风险回归模型分析HIV/AIDS死亡的相关因素。采用SPSS 23.0软件进行统计学分析。结果研究对象共72986例HIV/AIDS,死亡16634例,死亡病例以年龄≥40岁(68.5%,11393/16634)、男性(62.6%,10419/16634)、血液传播感染(71.7%,11927/16634)、农民/农民工(91.7%,15249/16634)为主。以因艾滋病相关疾病死亡为主(73.7%,12261/16634),病死率为16.8%(12261/72986)。34.6%(4237/12261)的HIV/AIDS在开始ART第1年因艾滋病相关疾病死亡,开始ART第10年和第18年的累积生存率分别为78.3%和71.8%。≥15岁HIV/AIDS开始ART的基线CD4+T淋巴细胞计数(CD4)<200个/μl的比例为45.5%(30432/66898)。Cox比例风险回归模型分析结果显示,研究对象基线CD4<200个/μl组和200~个/μl组的死亡风险分别是≥350个/μl组的1.78倍(95%CI:1.64~1.94)和1.24倍(95%CI:1.13~1.36);基线有症状的死亡风险是无症状的1.25倍(95%CI:1.16~1.35);最近1次病毒载量值≥1000拷贝数/ml的死亡风险是<1000拷贝数/ml的7.09倍(95%CI:6.65~7.54)。结论2002-2019年河南省ART≥15岁HIV/AIDS的死亡病例以血液传播感染和农民/农民工为主,艾滋病相关疾病是导致HIV/AIDS死亡的主要原因。随着河南省逐步推行ART策略,HIV/AIDS能长时间保持较高的生存率。应继续加强CD4检测工作,尽早纳入符合条件的HIV/AIDS进行规范化ART,以降低病死率、提高生存质量。
Objective To analyze the mortality in HIV/AIDS cases aged≥15 years under antiretroviral treatment(ART)in Henan province from 2002 to 2019,and provide evidence for reducing the mortality rate of HIV/AIDS and AIDS prevention and treatment.Methods Data of HIV/AIDS cases aged≥15 years who received ART in Henan from 2002 to 2019 were obtained from"Infectious Disease Surveillance System-Basic Information on AIDS Prevention and Control".In this retrospective study,Cox proportional risk model was used to analyze the influencing factors for HIV/AIDS related deaths.Software SPSS 23.0 was used for statistical analysis.Results From 2002 to 2019,a total of 72986 HIV/AIDS cases aged≥15 years received ART,in whom,16634 died during this period.Most of the death cases were aged≥40 years old(68.5%,11393/16634),males(62.6%,10419/16634),infected through blood-borne transmission(71.7%,11927/16634),and farmers or migrant workers(91.7%,15249/16634).Most of the deaths were due to AIDS related diseases(73.7%,12261/16634),and the case fatality rate was 16.8%(12261/72986).A total of 34.6%(4237/12261)of HIV/AIDS cases died of AIDS-related diseases in the first year of ART,and the cumulative survival rates at 10 and 18 years of ART were 78.3%and 71.8%,respectively.The proportion of the HIV/AIDS cases with baseline CD4+T lymphocyte(CD4)counts<200 cells/μl at age 15 years when ART started was 45.5%(30432/66898).Cox proportional risk regression model showed that,compared with the cases with baseline CD4 counts≥350 cells/μl,the risk of death was 1.78 times higher than in the cases with CD4 counts<200 cells/μl(95%CI:1.64-1.94)and 1.24 times higher in the cases with CD4 counts≥200 cells/μl(95%CI:1.13-1.36),respectively.The risk of death in symptomatic cases at baseline survey was 1.25 times higher than that in asymptomatic cases(95%CI:1.16-1.35).The cases with a latest viral load≥1000 copies/ml had 7.09 times higher risk of death than those with a last viral load<1000 copies/ml(95%CI:6.65-7.54).Conclusions The majority of HIV/AID
作者
杨文杰
刘洋
李洁
马彦民
李宁
Yang Wenjie;Liu Yang;Li Jie;Ma Yanmin;Li Ning(Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2021年第9期1594-1600,共7页
Chinese Journal of Epidemiology
基金
国家科技重大专项(2018ZX10715009)
河南省科技攻关计划(182102310188)。
关键词
艾滋病
抗病毒治疗
死亡状况
分析
AIDS
Antiretroviral treatment
Mortality
Analysis
