盐城市2005-2015年艾滋病抗病毒治疗患者生存分析

目的 探索盐城市2005-2015年首次接受抗病毒治疗的艾滋病病毒感染者(HIV)/艾滋病病人(AIDS)的生存时间及影响因素。 方法 利用中国疾病预防控制系统艾滋病综合防治信息系统收集盐城市2005-2015年HIV/AIDS的生存、死亡信息,采用寿命表法分析患者的生存率,采用Cox比例风险模型分析可能影响生存时间的因素。 结果 共有670例接受抗病毒治疗的病例纳入本次研究,截止到研究结束时,有48例病人死于艾滋病相关疾病,占7.16%。抗病毒治疗后患者1~5年的累积生存率分别为0.93、0.91、0.91、0.88和0.88。多因素Cox比例风险模型分析结果显示,首次确诊HIV阳性时年龄25~<50岁组的死亡风险低于年龄≥50岁组(HR=0.350,95%CI:0.196~0.625,P<0.001),相对于基线CD4^＋T淋巴细胞计数＜50个/mm³组,CD4^＋T淋巴细胞计数50~<200个/mm³组、≥200个/mm³组的病例死亡风险均降低(HR=0.447,95%CI:0.216~0.925,P=0.030;HR=0.286,95%CI:0.148~0.552,P<0.001)。 结论 首次确诊HIV阳性时的年龄和基线CD4^＋T淋巴细胞计数影响HIV/AIDS的生存时间,提示扩大HIV监测检测覆盖面,早诊早治是提高患者生存率的关键。

Survival of HIV/AIDS patients receiving antiretroviral therapy in Yancheng City, 2005-2015

Objective To analyze the survival time of HIV/AIDS patients who initially received antiretroviral treatment and its influencing factors in Yancheng City during 2005-2015. Methods The data about HIV/AIDS patients’ survival time and death in Yancheng City during 2005-2015 were collected from Chinese HIV/AIDS Integrated Control System. Life table method was employed to calculate the survival rate of the patients, and Cox proportional hazard regression model was used to analyze the factors possibly affecting the survival time. Results A total of 670 HIV/AIDS patients receiving antiretroviral therapy were enrolled in this study, and 48 (7.16%) patients died of AIDS-related illness at the end of the study. The cumulative survival rates of antiretroviral treatment after 1, 2, 3, 4 and 5 years were 0.93, 0.91, 0.91, 0.88 and 0.88 respectively. The Results of multivariate Cox proportional hazard regression model analysis indicated that HIV/AIDS cases aged 25-<50 years at the first diagnosis had a lower mortality risk than those ≥50 years (HR=0.350, 95%CI:0.196-0.625, P<0.001), and the cases with lower CD4⁺ T cell count of < 50/mm³ at baseline had a higher mortality risk than those with CD4⁺ T cell count of 50-<200/mm³ and ≥200/mm³ (HR=0.447, 95%CI:0.216-0.925, P=0.030; HR=0.286, 95%CI:0.148-0.552, P<0.001). Conclusions Age at first diagnosed HIV-positive and CD4⁺ T cell count at baseline affect the survival time of HIV/AIDS patients, indicating that the coverage of HIV surveillance and testing needs to be expanded, and early diagnosis and early treatment of HIV/AIDS are the key to improve thepatients^, survival rate.