张家界市1995-2012年老年人HIV感染者死亡及其影响因素分析

目的 分析张家界市1995-2012年老年人HIV感染者死亡及其影响因素.方法 将全国艾滋病疫情报告系统中1995-2012年户籍和现住址均为张家界市的老年人HIV感染者作为研究对象,结合张家界市的人口数据计算死亡率;采用Kaplan-Meier法估计老年人HIV感染者生存率曲线,用Cox回归模型分析其死亡的影响因素.结果 张家界市老年人HIV年平均死亡率为2.56/10万,并呈逐年上升趋势(x2趋势=164.38,P＜0.001),其中位生存时间为25.00个月.Cox回归模型分析显示:是否进行抗病毒治疗(RR=0.141,95％ CI:0.073～0.271),艾滋病确诊年限(RR=0.468,95％ CI:0.297～0.738)和CD4+T淋巴细胞基线计数数量(RR=0.271,95％ CI:0.162 ～0.454)是HIV感染者死亡的主要影响因素.结论 张家界市老年人HIV死亡率有逐年升高的趋势.是否进行抗病毒治疗、CD4+T淋巴细胞基线计数和艾滋病确诊年限是其死亡的主要影响因素.

Analysis on the death and risk factors among older HIV-positive adults in Zhangjiajie City ,1995 -2012

Objective To analyze the death and the determinants among older HIV-positive adults in Zhangjiajie City, 1995 -2012. Methods Older HIV-positive adults during 1995 -2012 in Zhangjiajie, who held local residency and household registration in China Information System For Disease Control And Prevention, were included in the analysis. Based on the data from Zhangjiajie demographics, mortality rates were calculated. Kaplan-Meier method was used to estimate the survival curves, and proportional hazards regression model was conducted to examine the risk factors for deaths. Results The average annum mortality rate of older HIV-positive adults in Zhangjiajie was 2. 56/100 000 and annual mottality rate showed increasing（Хtrend^2 = 164. 38, P 〈 0. 001 ） . The median survival time was 25.00 months overall. Data from multiple regression analysis indicated that antiretroviral-treatment （ART） （RR =0. 141,95% CI：0. 073-0. 271 ） ,the baseline CD4 ^＋T cell count （RR =0. 271,95% CI：0. 162-0. 454）and the time length of diagnosis of AIDS（ RR = 0. 468,95% CI：0. 297-0. 738） were closely associated with death among older HIV-positive adults. Conclusions The mortality rate of older HIV-positive adults has a tendency to increase. The ART,the baseline CD4^＋T cell count and the time length of diagnosis of AIDS are main influencing factors for deaths.