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昭觉县成年HIV/AIDS接受抗病毒治疗后生存分析
引用本文:孙晓蒙, 马方华, 赵建伟, 卓玛拉措, 贺亚萍, 达争此吉, 袁新皓, 栾荣生. 昭觉县成年HIV/AIDS接受抗病毒治疗后生存分析[J]. 中华疾病控制杂志, 2018, 22(12): 1221-1224,1247. doi: 10.16462/j.cnki.zhjbkz.2018.12.005
作者姓名:孙晓蒙  马方华  赵建伟  卓玛拉措  贺亚萍  达争此吉  袁新皓  栾荣生
作者单位:1. 四川大学华西公共卫生学院流行病与卫生统计学系, 四川 成都 610041;;;2. 昭觉县人民医院抗病毒治疗中心, 四川 凉山 616150;;;3. 四川大学公共管理学院行政管理系, 四川 成都 610041;;;4. 昭觉县疾病预防控制中心艾滋病科, 四川 凉山 610050
基金项目:四川省昭觉县统筹城乡的艾滋病综合防控体系建设(2012GS510101)
摘    要:目的 了解凉山州昭觉县成年获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者接受抗病毒治疗后的生存状况,并探讨其影响因素。方法 采用回顾性队列研究方法,以昭觉县2005年1月1日~2017年3月20日入组参加抗病毒治疗的成年HIV/AIDS为研究对象,收集其生存死亡信息,采用生存分析方法对研究对象进行生存时间及其影响因素的分析。结果 截止观察日止,2 216例研究对象中仍在治疗者1 528人(68.95%),因艾滋病死亡者222人(10.02%),平均生存时间为17.64月,中位生存时间13月,治疗时间少于12月者99人(44.59%)。第1~5年的累计生存率为0.93、0.90、0.88、0.86、0.85。Cox比例风险回归模型分析显示,年龄、基线CD4+T细胞计数、初始治疗方案、入组治疗时是否存在艾滋病相关疾病或症状是影响生存时间的因素(均有P<0.05)。结论 昭觉县艾滋病抗病毒治疗降低了艾滋病死亡率,延长了患者的生存时间;在抗病毒治疗过程中存在多种因素影响对患者生存状况,及早发现HIV感染者并及时纳入治疗能有效提高高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)治疗成效。

关 键 词:艾滋病   高效抗逆转录病毒疗法   生存分析
收稿时间:2017-11-14
修稿时间:2018-03-26

Survival analysis of HIV/AIDS adult patients receiving antiretroviral therapy in Zhaojue
SUN Xiao-meng, MA Fang-hua, ZHAO Jian-wei, ZHUOMA Lacuo, He Ya-ping, DA Zheng-Ciji, YUAN Xin-hao, LUAN Rong-sheng. Survival analysis of HIV/AIDS adult patients receiving antiretroviral therapy in Zhaojue[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2018, 22(12): 1221-1224,1247. doi: 10.16462/j.cnki.zhjbkz.2018.12.005
Authors:SUN Xiao-meng  MA Fang-hua  ZHAO Jian-wei  ZHUOMA Lacuo  He Ya-ping  DA Zheng-Ciji  YUAN Xin-hao  LUAN Rong-sheng
Affiliation:1. Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, China;;;2. AIDS Antiviral Treatment Center of The People's hospital, Zhaojue 616150, China;;;3. Department of Administrative Management, School of Public Administation, Sichuan University, Chengdu 610041, China;;;4. Department of AIDS Control and Prevention, Zhaojue Center for Disease Prevention and Control, Zhaojue 616150, China
Abstract:Objective To explore the survival and its influencing factors among adult human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients of highly active antiretroviral therapy (HAART) program in Zhaojue county, Liangshan prefecture. Methods A retrospective cohort study was conducted among HIV/AIDS patients who received antiretroviral therapy from January 1st, 2005 to March 20th, 2017. Survival data of patients were collected. Survival time and its related factors were analyzed by survival analysis. Results Of all the patients, 1 528(68.95%) were still under the therapy, 222(10.02%) died of AIDS, the average survival time of them was 33.76 months, and the median was 13 months,99(44.59%) had the treatment duration of less than 1 year. The cumulative survival rates were 0.93, 0.90, 0.88, 0.86, 0.85 from 2006 to 2010. Cox proportional hazard regression suggested that the survival time was associated with the age at therapy initiation, baseline CD4+T cell count, and AIDS-related diseases or symptoms before treatment. Conclusions The national free treatment program had significantly reduced the AIDS mortality rate, prolonged the patient's survival time in Zhaojue. There were several factors that affected the patient's survival during the treatment, some effective measures should be taken to improve HAART treatment effectiveness,such as early detection of HIV/AIDS and timely treatment.
Keywords:HIV  highly active antiretroviral therapy  Survival analysis
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