摘要
目的分析河南省2002—2020年接受抗病毒治疗(ART)10年及以上≥15岁HIV感染者和AIDS患者(HIV/AIDS)的生存状况及影响因素。方法采用回顾性队列研究设计,从中国艾滋病综合防治信息系统中收集河南省2002年1月1日至2020年12月31日的HIV感染者和AIDS患者数据,对最终符合纳入标准(住址为河南省;接受ART治疗满10年时仍存活;有完整的基线和随访信息者,如人口学特征、CD4+T淋巴细胞计数、病毒载量等)的20 256例研究对象采用Cox比例风险回归模型分析HIV/AIDS生存状况的相关影响因素。结果 20 256例研究对象共计随访82 738.2人年,平均随访4.1人年;男女比例为1∶1.06;接受ART治疗10年时年龄为(51.2±8.7)岁;感染途径以血液传播(85.5%)为主;已婚者占71.2%;88.5%研究对象在村/乡级治疗机构接受治疗。共计死亡2 030例(10.0%),其中因艾滋病相关疾病死亡1 897例(93.5%),病死率为9.4%(1 897/20 256)。多因素Cox比例风险回归模型分析主要结果显示,与起始年龄25~39岁组患者相比,40~54岁、55~69岁、≥70岁年龄组患者死亡风险较高,HR(95%CI)值分别为1.57(1.19~2.08)、3.78(2.86~4.99)和6.17(4.33~8.79);与起始CD4+T淋巴细胞计数≥350个/μl组相比,200~349个/μl组和<200个/μl组患者死亡风险较高,HR(95%CI)值分别为1.81(1.61~2.04)和3.64(3.20~4.15);与起始病毒载量结果<1 000拷贝/ml患者相比,≥1 000拷贝/ml的患者死亡风险较高,HR(95%CI)值为1.73(1.52~1.97);与接受一线ART方案患者相比,接受二线ART方案患者的死亡风险较低,HR(95%CI)值为0.12(0.11~0.14)。结论 2002—2020年河南省接受ART治疗10年以上HIV/AIDS生存率较高;年龄、CD4+T淋巴细胞计数、病毒载量等均为HIV/AIDS生存的影响因素。
Objective To analyze the survival and influencing factors of HIV infections and AIDS cases(HIV/AIDS)aged 15 years and over who had received antiretroviral treatment(ART)for more than 10 years in Henan Province.Methods In this retrospective cohort study,data of HIV infections and AIDS cases in Henan province were collected from the AIDS Prevention and Control System between January 1,2002 and December 31,2020.This study included 20256 participants alive after 10-year ART with complete baseline and follow-up information,such as demographic characteristics,CD4+T lymphocyte count and viral load.Cox proportional risk regression model was used to analyze influencing factors of HIV/AIDS survival.Results A total of 20256 participants were followed up for 82738.2 person-years,with an average follow-up of 4.1 person-years,of which most cases were blood transmission(85.5%)and married(71.2%).The male to female ratio was 1∶1.06 and the age at 10 years of ART was(51.2±8.7)years old.About 88.5%of HIV/AIDS patients received ART in village/township treatment institutions.Overall,there were 2030 deaths during this period,among which 1897 were due to AIDS-related diseases(93.5%)and the case fatality rate was 9.4%(1897/20256).Cox proportional risk regression model showed that participants aged 40-54,55-69,and≥70 years had a higher risk of death compared to those aged 25-39,with adjusted HRs(95%CI)of 1.57(1.19-2.08),3.78(2.86-4.99),and 6.17(4.33-8.79),respectively.Participants with the initial CD4+T lymphocyte count about 200-349/μl and<200/μl had a higher risk of death compared to those with initial CD4+T lymphocyte count≥350/μl,with adjusted HRs(95%CI)of 1.81(1.61-2.04)and 3.64(3.20-4.15),respectively.Participants with the initial viral load outcome≥1000 copies/ml had a higher risk of death compared to those with the initial viral load outcome<1000 copies/ml,with adjusted HRs(95%CI)of 1.73(1.52-1.97).Participants receiving the second-line ART had a lower risk of death compared to those receiving the first-line ART,with adjusted HRs(95%CI)of 0.12(0.11-0.14).Conclusion From 2002 to 2020,the survival rate of HIV/AIDS treated with ART for more than 10 years is high in Henan Province.Age,CD4+T lymphocyte count and viral load are influencing factors of HIV/AIDS survival.
作者
杨文杰
李洁
马彦民
刘洋
轩水丽
李宁
Yang Wenjie;Li Jie;Ma Yanmin;Liu Yang;Xuan Shuili;Li Ning(Institute for Chronic and Noncommunicable Disease Control and Prevention,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2022年第7期919-925,共7页
Chinese Journal of Preventive Medicine
基金
国家科技重大专项(2018ZX10715009)
河南省科技攻关计划项目(202102310441)。
关键词
获得性免疫缺陷综合征
抗病毒治疗
生存分析
Acquired immunodeficiency syndrome
Antiretroviral treatment
Survival analysis
