摘要
目的分析1995-2019年新乡市HIV/AIDS病例的生存时间及影响因素,为在不同人群开展艾滋病精准防治提供依据。方法从全国艾滋病综合防治信息系统中导出1995-2019年HIV/AIDS病例报告卡和随访数据,以寿命表法计算其生存率,采用Kaplan-Meier法拟合不同状态下的生存曲线,Cox比例风险模型分析HIV/AIDS生存时间的影响因素。结果2217例HIV/AIDS患者纳入随访观察队列,全死因死亡率6.02/100人年,平均生存时间(135.656±2.194)月(95%CI:131.355~139.959),第1、3、5和10年累积生存率分别为85.33%、79.83%、74.29%和64.25%。多因素Logistic回归分析显示:与<20岁年龄组比较,≥60岁年龄组(OR=2.857,95%CI:1.354~6.028)的病例死亡风险较高;与初中及以下文化程度组比较,高中及以上文化程度组(OR=0.635,95%CI:0.475~0.850)的病例死亡风险较低;与同性传播组比较,通过异性传播(OR=1.519,95%CI:1.030~2.240)、注射毒品(OR=2.644,95%CI:1.084~6.446)和血液传播(OR=2.064,95%CI:1.364~3.124)死亡风险较高;与未接受抗病毒治疗组比较,接受抗病毒治疗组(OR=0.128,95%CI:0.104~0.159)死亡风险较低;首次CD4^(+)T淋巴细胞(CD4)计数:与<200个/μL组比较,200~349个/μL组(OR=0.382,95%CI:0.279~0.522)、350~499个/μL组(OR=0.378,95%CI:0.272~0.524)、≥500个/μL组(OR=0.258,95%CI:0.180~0.370)死亡风险较低,而未检测组(OR=1.434,95%CI:1.124~1.829)的病例死亡风险较高。结论1995-2019年新乡市HIV/AIDS病例全死因死亡率较高,确诊时年龄、文化程度、感染途径、是否接受抗病毒治疗以及首次CD4检测结果是HIV/AIDS病例生存时间的主要影响因素,应加强艾滋病防治知识宣教,及早进行艾滋病检测和接受抗病毒治疗。
Objective By analyzing the survival time of HIV/AIDS cases in Xinxiang from 1995 to 2019 and its influencing factors,to provide guidance for precise prevention and treatment of AIDS among different groups of people.Methods Data of all cases including reporting cards and follow-up cards were collected from the China disease prevention and control information system.Life table method was applied to calculate survival rate.Kaplan-Meier method was used to draw survival curve.Cox proportional hazards model was used to analyze the influencing factors of survival time.Results A total of 2217 HIV/AIDS cases were included in the cohort.The all-cause mortality rate was 6.02/100 person-years,the average survival time was(135.656±2.194)months(95%CI:131.355-139.959)and the survival rates in 1,3,5 and 10 years were 85.33%、79.83%、74.29%and64.25%.Cox multivariate analysis showed that compared with the age group less than 20 years old,the death risk of cases in the age group≥60 years old(OR=2.857,95%CI:1.354-6.028)was higher.Compared with the group with junior high school education or below,the group with senior high school education or above(OR=0.635,95%CI:0.475-0.850)had a lower risk of death.Compared with the homosexual transmission group,through heterosexual transmission(OR=1.519,95%CI:1.030-2.240),drug injection(OR=2.644,95%CI:1.084-6.446)and blood transmission(OR=2.064,95%CI:1.364-3.124)had higher riek of death.Compared with the group without antiviral treatment,the risk of death in the group receiving antiviral treatment(OR=0.128,95%CI:0.104-0.159)was lower.The first CD4;T lymphocyte count:compared with<200 cells/μL group,200-349 cells/μL(OR=0.382,95%CI:0.279-0.522),350-499 cells/μL(OR=0.378,95%CI:0.272-0.524),≥500 cells/μL(OR=0.258,95%CI:0.180-0.370)was lower,the risk of death in the undetected group(OR=1.434,95%CI:1.124-1.829)was higher.Conclusion The all-cause mortality rate of HIV/AIDS patients is relatively high.Main influencing factors for survival in HIV/AIDS patients are the age at first diagnosis,educ
作者
王静
席瑾
王瑗瑗
WANG Jing;XI Jin;WANG Yuanyuan(Xinxiang Center for Disease Control and Prevention,Xinxiang,Henan 453000,China)
出处
《河南预防医学杂志》
2022年第1期44-48,共5页
Henan Journal of Preventive Medicine
