摘要
目的了解1996—2021年湖北省荆州市艾滋病病毒感染者和艾滋病患者(HIV/AIDS)确证后1年内死亡情况,为促进艾滋病早发现早治疗提供依据。方法通过中国疾病预防控制信息系统艾滋病综合防治信息系统收集1996—2021年荆州市HIV/AIDS病例的基本情况和随访资料,分析确证后1年内死亡密度及变化趋势,以及死亡病例的人口学特征、检测发现、治疗和死亡原因等情况;采用Cox比例风险回归模型分析确证后1年内死亡的影响因素。结果纳入HIV/AIDS病例3304例,确证后1年内死亡508例,死亡密度为17.43/100人年,1996—2021年死亡密度呈下降趋势(χ^(2)_(趋势)=21.053,P<0.001)。死亡病例中,男性占77.76%,≥45岁占67.72%,异性性接触感染占83.86%,医疗机构检测发现占83.66%,未进行ART占62.20%,未检测CD4细胞占47.83%,死亡原因为艾滋病无关死亡占58.86%。确证年龄≥30岁(HR:1.781~4.644,95%CI:1.073~7.784)、医疗机构检测发现(HR=2.130,95%CI:1.306~3.474)、首次CD4^(+)T淋巴细胞(CD4细胞)计数<200个/μL(HR:2.649~12.879,95%CI:1.669~19.189)、未进行ART(HR=7.945,95%CI:5.743~10.993)和确证后4~12个月启动ART(HR=1.636,95%CI:1.005~2.662)的病例确证后1年内死亡风险较高。结论1996—2021年荆州市HIV/AIDS病例确证后1年内死亡密度呈下降趋势;确证年龄较大,经异性性接触感染、医疗机构检测发现、CD4细胞水平低、ART不及时或未进行ART与确证后1年内死亡有关。
Objective To investigate the characteristics of dead HIV/AIDS cases within 1 year after confirmatory testing in Jingzhou City,Hubei Province from 1996 to 2021,so as to provide the evidence for facilitating early identification and treatment of AIDS.Methods The basic and follow-up data of HIV/AIDS cases were retrieved from the HIV/AIDS Comprehensive Response Information System of Chinese Disease Prevention and Control Information System,and mortali⁃ty density and its trend were evaluated within 1 year after confirmatory testing.The factors affecting death within 1 year after confirmatory testing were identified using a Cox proportional hazards model,and the demographics,detection,treatment and cause of death were analyzed among dead HIV/AIDS cases within 1 year after confirmatory testing.Results A total of 3304 HIV/AIDS cases were included,with 508 deaths within 1 year after confirmatory testing.The overall mortality density was 17.43 per 100 person-years,and the mortality density appeared a tendency towards a reduction from 1996 to 2021(χ^(2)_(trend)=21.053,P<0.001).Of all dead HIV/AIDS cases within 1 year after confirmatory test⁃ing,77.76%were men,67.72%at ages of 45 years and older,83.86%with transmission by heterosexual contact,83.66%identified in medical institutions,62.20%without antiretroviral therapy,and 47.83%without detection of CD4^(+)T cell count.Mortality that was not associated with AIDS was the predominant cause of death among dead HIV/AIDS cas⁃es within 1 year after confirmatory testing(58.86%).Age of 30 years and older(HR:1.781-4.644,95%CI:1.073-7.784),identification in medical institutions(HR=2.130,95%CI:1.306-4.474),initial CD4^(+)T cell count of<200 cells/μL(HR:2.649-12.879,95%CI:1.669-19.189),no antiretroviral therapy(HR=7.945,95%CI:5.743-10.993)and initiation of antiretroviral therapy 4 to 12 months after confirmatory testing(HR=1.636,95%CI:1.005-2.662)resulted in a higher risk of mortality within 1 year after confirmatory testing.Conclusions The mortality density appeared a tendency
作者
蔺茂文
刘锐
张凡
李舒超
刘建昭
豆智慧
孙春
LIN Maowen;LIU Rui;ZHANG Fan;LI Shuchao;LIU Jianzhao;DOU Zhihui;SUN Chun(Department of AIDS/STD Control and Prevention,Jingzhou Center for Disease Control and Prevention,Jingzhou,Hubei 434000,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Jingzhou Center for Disease Control and Prevention,Jingzhou,Hubei 434000,China)
出处
《预防医学》
2023年第5期396-400,共5页
CHINA PREVENTIVE MEDICINE JOURNAL
关键词
艾滋病
死亡
抗病毒治疗
AIDS
death
antiretroviral therapy
