贵港市老年HIV/AIDS患者生存状况及其影响因素的回顾性队列研究

 

目的 了解贵港市老年人类免疫缺陷病毒感染者/艾滋病患者（HIV/AIDS）的生存状况及其影响因素，为制定有针对性的防治措施提供参考依据。方法 采用回顾性队列研究，在艾滋病综合防治信息系统中选择年龄≥50岁的HIV/AIDS患者作为研究对象，用寿命表法计算生存率，Kaplan-Meier法绘制生存曲线，Log-Rank检验比较不同组别生存时间的差异，Cox比例风险模型进行多因素分析。结果 5 397例研究对象中，死亡2 466例，其中艾滋病相关死亡931例。累计观察164 122.77人月，艾滋病相关死亡率为5.67/1 000人月。平均生存时间为129.680个月（95%CI：127.513~131.846），确诊后第12、36、60、96个月的生存率分别为81%、78%、77%、76%。多因素Cox回归分析显示，男性、汉族、AIDS、以性接触为主的感染途径、低CD4⁺T细胞水平及未检测者、未接受抗病毒治疗（ART）均是影响老年HIV/AIDS生存时间的危险因素。结论 贵港市老年HIV/AIDS的生存率低，生存时间受多种因素的影响，故须针对该类人群的特点，采取有效的综合防治措施，降低死亡风险，延长生存时间。

A retrospective cohort study on survival status and influencing factors of elderly HIV/AIDS patients in Guigang City

Objective To understand the survival status and influencing factors of elderly patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Guigang City, and provide reference for the formulation of targeted prevention and control measures. Methods A retrospective cohort study was conducted to select HIV/AIDS patients aged ≥ 50 years from the comprehensive AIDS prevention and control information system as studied subjects, survival rate was calculated with table method, survival curve was drawn with Kaplan-Meier method, difference in survival time of different groups was compared with Log-Rank test, multivariate analysis was conducted by Cox proportional hazard model. Results Of the 5 397 studied subjects, 2 466 died, including 931 AIDS-related deaths. A total of 164 122.77 person-months were observed, HIV-related mortality was 5.67/1 000 person-months. The mean survival time was 129.680 months (95%CI:127.513-131.846), survival rates of these patients were 81%, 78%, 77%, and 76% at 12, 36, 60, and 96 months respectively after diagnosis. Multivariate Cox regression analysis showed that male, Han nationality, AIDS, sexual contact-based infection routes, low CD4⁺T cell level or undetected persons, not receiving antiretroviral therapy(ART) were all risk factors for survival time of elderly HIV/AIDS patients. Conclusion The survival rate of elderly people with HIV/AIDS in Guigang City is low, and survival time is affected by many factors, effective comprehensive prevention and control measures should be taken to reduce the risk of death and prolong the survival time.