1995-2017年贵州省HIV/AIDS病例死亡情况分析

  目的  了解1995-2017年贵州省艾滋病病毒感染者/艾滋病患者(human immunodeficiency virus/acquired immuno deficiency syndrome，HIV/AIDS)的死亡分布情况。  方法  通过"艾滋病综合防治信息系统"，下载HIV/AIDS病例报告卡(现住址为贵州省、截止时间至2017年12月31日)，对其中的信息进行统计分析。  结果  1995-2017年共报告现住址为贵州省的HIV/AIDS 43 794例，死亡11 527例，排除失访及查无此人病例，全省HIV/AIDS死亡率为29.8%；HIV/AIDS当年发病当年死亡病例数、年初存活当年死亡病例数占当年发病总病例数的比例在1995-2017年均呈现出由低到高(χ_1995-20122=139.5，P < 0.001；χ_1995-20122=109.1，P < 0.001)再降低(χ_2012-20152=28.2，P < 0.001；χ_2012-20142=57.2，P < 0.001)，最终逐渐趋于平稳(χ_2015-20172=0.056，P=0.812；χ_2015-20172=0.720，P=0.396)的变化趋势；分析死亡病例的检测史，辅助T淋巴细胞(cluster of differentiation 4，CD4)检测比例(χ_趋势2=367.4，P < 0.001)及抗病毒治疗比例(χ_趋势2=319.8，P < 0.001)均呈逐年上升的趋势；死因分析发现，死因为艾滋病所占的比例呈现出先上升(χ_1995-20102=78.5，P < 0.001)后下降(χ_2010-20122=1 667.5，P < 0.001)的趋势；而死因为吸毒过量所占的比例呈现逐年下降(χ_趋势2=14.4，P < 0.001)的趋势。  结论  近年来贵州省HIV/AIDS的死亡率依然较高、下降速度缓慢，继续扩大HIV监测检测覆盖面，积极推广CD4+T淋巴细胞检测及免费抗病毒治疗以降低HIV/AIDS的死亡率仍是今后一段时间贵州省艾滋病防治工作在的重点之一。

Mortality analysis among HIV/AIDS cases in Guizhou Province from 1995 to 2017

  Objective  To investigate the distribution of death among human immunodeficiency virus/acquired immuno deficiency syndrome(HIV/AIDS) cases in Guizhou Province from 1995 to 2017.  Methods  The HIV/AIDS death cases from 1995 to 2017 were downloaded from "Chinese National Comprehensive HIV/AIDS Prevention and care Information system" in Guizhou Province and were analyzed.  Results  From 1995 to 2017, Guizhou Province reported a total of 43 794 HIV/AIDS cases and 11 527 deaths according to current address. After excluding missing persons, the HIV/AIDS mortality rate of the province was 29.8%. The proportion of reported HIV/AIDS cases died in the same year (χ_1995-20122=139.5, P < 0.001;χ_2012-20152=28.2, P < 0.001) and the proportion of HIV/AIDS cases (χ_1995-20122=109.1, P < 0.001;χ_2012-20142=57.2, P < 0.001) who survived at the beginning but died later in the year all showed a trend being low-high-low. In the analysis of the detection history of death cases, the detection proportion of cluster of differentiation 4(CD4) T-cell and the proportion of antiviral treatment had been increasing year by year. The analysis of the cause of death found that the proportion of death caused by AIDS increased firstly and then declined, and the proportion of death due to excessive drug abuse showed a trend of declining year by year.  Conclusions  The mortality rate of HIV/AIDS in Guizhou Province was still high, and decreased rather slow. Expanding the coverage of HIV monitoring and screening is one of the key tasks of AIDS prevention and control. CD4+T-cell testing and free antiviral treatment should be strengthened to reduce the mortality rate of HIV/AIDS in Guizhou Province in the future.