柳州市2005-2020年新发HIV感染者疾病进展及其影响因素

  目的  了解柳州市新发HIV感染者进展为AIDS的进程，探讨可能影响疾病进展的因素。  方法  采用回顾性队列研究方法，从艾滋病综合防治信息系统查询柳州市2005年1月1日-2020年12月31日新报告且接受高效抗逆转录病毒治疗(highly active anti-retroviral therapy, HAART)的HIV感染者信息。通过Kaplan-Meier法计算平均潜伏期，寿命表法计算艾滋病的进展率和累积未进展率，采用多因素Cox比例风险模型分析HIV进展为AIDS的影响因素。  结果  9 905例HIV感染者的平均潜伏期为6.01(95% CI: 5.86~6.16)年，第1、3、5、10年累积未进展率分别为57.03%、46.64%、39.45%和27.39%。多因素Cox回归分析显示:男性(HR=1.10, 95% CI: 1.03~1.17, P=0.003)、确诊时年龄≥40岁(40~ < 60岁:HR=1.50, 95% CI: 1.20~1.88, P < 0.001;≥60岁:HR=1.57, 95% CI: 1.24~1.98, P < 0.001)、首次诊断时CD4+T淋巴细胞计数 < 200个/μl(HR=5.51, 95% CI: 5.10~5.95, P < 0.001)、已婚有配偶(HR=1.10, 95% CI: 1.02~1.18, P=0.010)和异性性接触传播(HR=1.84, 95% CI: 1.47~2.31, P < 0.001)者AIDS发病风险增加。  结论  柳州市新发HIV感染者进展为AIDS的速度较快，应针对危险因素改善相应的公共卫生和医疗服务，以减缓疾病进展。

Disease progression and influencing factors of newly HIV-infected patients in Liuzhou City from 2005 to 2020

  Objective  To understand the progress of newly HIV infected people into AIDS in Liuzhou City, and to explore factors that may have effects on the progress of the disease.  Methods  A retrospective cohort study was conducted. Newly reported HIV-infected patients with highly active anti-retroviral therapy (HAART) in Liuzhou City from January 1, 2005 to December 31, 2020 were selected from the National Comprehensive AIDS Prevention and Control Information System, and relative data were obtained. The mean incubation period was calculated by Kaplan-Meier. Life table method was used to calculate the incidence and cumulative non-incidence of AIDS. Furthermore, multivariate Cox proportional-hazards model was performed on the influencing factors of HIV disease progression.  Results  The mean incubation period of 9 905 HIV-infected cases was 6.01(95% CI: 5.86-6.16) years. The cumulative non-incidence of AIDS in 1, 3, 5, 10 years were 57.03%, 46.64%, 39.45% and 27.39%, respectively. Multivariate Cox proportional-hazards model analysis showed that male (HR=1.10, 95% CI: 1.03-1.17, P=0.003), age of onset ≥40 years (40-<60 years old: HR=1.50, 95% CI: 1.20-1.88, ≥ 60 years old: HR=1.57, 95% CI: 1.24-1.98, all P < 0.05), CD4+T lymphocyte count at first diagnosis < 200 cells/μl (HR=5.51, 95% CI: 5.10-5.95, P < 0.001), married (HR=1.10, 95% CI: 1.02-1.18, P=0.010) and heterosexual transmission (HR=1.84, 95% CI: 1.47-2.31, P < 0.001) increased the risk of AIDS.  Conclusions  Newly HIV-infected patients in Liuzhou develop into AIDS rapidly. Therefore, corresponding public health and medical services should be improved to slow down the disease progression.