成都市50岁及以上HIV/AIDS抗病毒治疗后生存分析

  目的  了解成都市50岁及以上艾滋病病毒感染者和艾滋病病人(HIV/AIDS)在接受抗病毒治疗后的生存情况，探讨50岁及以上HIV/AIDS抗病毒治疗后生存的影响因素，为制定50岁及以上HIV/AIDS治疗政策提供依据。  方法  选择成都市2010-2018年新报告的50岁及以上接受抗病毒治疗的HIV/AIDS，采用寿命表法描述生存情况，通过多因素Cox风险回归模型对可能的影响因素进行分层并进行生存分析。  结果  治疗后20个月内累计生存率从0.97下降到0.91，截至观察终点时间9年累计生存率为0.82。多因素分析显示:女性发生死亡危险是男性的0.689倍；70岁及以上发生死亡危险是50~岁的4.037倍；未婚和离异丧偶发生死亡危险是已婚的1.909倍和1.269倍；大专及以上发生死亡危险是文盲的0.403倍；首次CD4+T细胞检测值>500个/mm3发生死亡危险是 < 100个/mm3的0.318倍。  结论  成都市50岁及以上HIV/AIDS抗病毒治疗后的生存率较高，性别、年龄、文化程度、婚姻状况、首次CD4+T细胞检测值是影响50岁及以上HIV/AIDS病人生存的因素，应根据本地区实际情况，制定相应的治疗措施与宣传手段。

Analysis of survival of HIV/AIDS aged 50 years and above in Chengdu after antiretroviral therapy

  Objective  To understand the survival of HIV/AIDS aged 50 years and above in Chengdu after receiving antiretroviral therapy(ART), and to explore the factors affecting the survival of HIV/AIDS aged 50 years and above after ART, so as to provide the basis for the health authorities at all levels to formulate the treatment policy for HIV/AIDS aged 50 years and above.  Methods  The HIV/AIDS aged 50 years and above who were receiving ART in Chengdu from 2010 to 2018 were selected. Life-table method was used to describe the survival situation. Survival analysis method was used to stratify the study subjects according to the factors by the Cox risk regression model.  Results  The cumulative survival rate decreased from 0.97 to 0.91 within 20 months after treatment, and the cumulative survival rate was 0.82 at 9 years up to the end point of observation. Cox multivariate analysis showed that the risk of death in women was 0.689 times than in men. The aged 70 years and above was 4.037 times than the aged from 50 to 54 years old. Spinsterhood and divorced were 1.909 and 1.269 times than married. The college and above was 0.403 times than illiteracy. The first CD4+T cell test value of >500 /mm3 was 0.318 times higher than < 100 /mm3.  Conclusions  The survival rate of AIDS patients aged 50 years and above after ART is high. The factors such as age, education level and marital status affect the survival of AIDS patients aged 50 years and above. Corresponding treatment measures and publicity means should be developed according to the actual situation in Chengdu.