湖北省2003-2015年艾滋病抗病毒治疗死亡病例流行病学分析

目的 分析湖北省艾滋病抗病毒治疗死亡病例的流行病学特征,为降低病人死亡率,提高抗病毒治疗效果提供依据.方法 通过“国家艾滋病综合防治信息系统”,筛选1416例年龄≥15岁的艾滋病抗病毒治疗死亡患者信息,采用SPSS21.0进行统计分析.结果 死亡的1 416例艾滋病患者中,男性占68.67％,女性占31.33％,年龄最小的16岁,最大的87岁,平均死亡年龄(47.68± 12.67)岁,感染途径以性传播为主,占62.01％,婚姻状况以已婚或同居为主,占60.31％,文化程度以初中及以下水平为主,占88.7％;死亡病例在接受抗病毒治疗的3个月内病死率最高,为37.22％.所有死亡病例中,64.76％死于艾滋病相关疾病,Kaplan-Meier法生存分析显示,抗病毒治疗开始的第1年患者生存率下降最快,Log-Rank检验(P＜ 0.000 1)发现基线CD4计数≤50个/μL的生存率低于基线CD4计数为51～200个/μL组和≥201个/μL组.结论 湖北省艾滋病抗病毒治疗死亡病例病死率较高,应加强患者的早发现和早治疗,降低病死率.

Epidemiological analysis of death cases of antiretroviral therapy for AIDS in Hubei, 2003-2015

Objective To analyze the epidemiological characteristics of death cases of antiretroviral therapy for AIDS in Hubei Province,so as to provide evidences for reducing the mortality and improving the effectiveness of antiviral treatment.Methods Through the "National AIDS Prevention and Control Information System”,the information of 1 416 death patients aged ≥15 years was screened and analyzed by SPSS21.0.Results Among 1 416 death AIDS patients,68.67％ of them were males and 31.33％ were females,the youngest was 16 years old,the oldest was 87 years old,and the average age of death was (47.68 ± 12.67) years.The main route of infection was the sexual transmission,accounting for 62.01％.In marital status,the majority was married or cohabiting persons (60.31％).In educational level,the majority was persons with junior high school or below education (88.7％).The highest fatality rate (37.22％) occurred during 3 months from antiviral treatment.In all the cases,64.76％ died of AIDS related diseases.The Kaplan-Meier survival analysis showed that during the first year from antiviral therapy start,the survival rate decreased most quickly.The Log-Rank test (P ＜ 0.000 1) found that the survival rate in the group of the baseline CD4 count being less than 50/μL was lower than that of the baseline CD4 count being 51-200/μL group and above 201/μL group.Conclusion The mortality rate of AIDS antiviral treatment is higher in Hubei Province,and therefore,early detection and early treatment should be strengthened to reduce the fatality rate.