湖北省黄石市2000—2019年HIV/AIDS死亡病例分析

目的 分析黄石市2000—2019年艾滋病毒感染者及艾滋病（HIV /AIDS）病人死亡情况及死亡相关影响因素,探讨减少死亡的方法。方法 从国家“艾滋病综合防治数据信息管理系统”中下载相关卡片,运用Excel 2007和SPSS 21.0软件对数据库进行整理和统计分析。结果 2 361例HIV /AIDS患者累计死亡760例,累计病死率32.19%。死亡时50岁以上患者600例（占78.95%）,73.15%（556/760）的患者接受过CD4⁺T淋巴细胞检测,其中65.11%（362/556）的患者检测值<200 个/μL;50.79%（386/760）的死亡病例接受过抗病毒治疗;54.61%（415/760）的死亡病例确诊后1年内死亡,多因素二项Logistic回归分析发现其他就诊者（OR=5.081,95%CI=2.776~9.302）、未接受抗病毒治疗（OR=4.716,95%CI=3.002~7.407）、最近1次CD4⁺T淋巴细胞值<200个/μL（OR=8.550,95%CI=4.289~17.046）和未检测的患者（OR=29.392,95%CI=13.466~64.155）更容易在1年内死亡。艾滋病相关死因占比逐年下降,至2017年为39.13%。死亡时患者平均年龄从2001年的37.39岁增长到2019年的66.86岁。结论 黄石市HIV /AIDS累计病死率较高,死亡时平均年龄高于全国平均水平,且呈逐年升高趋势,晚发病例更容易在确诊后1年内死亡,抗病毒治疗覆盖率不断提高,艾滋病无关死亡占比和患者生存时间不断增长。应继续开展早发现、早治疗工作,提升抗病毒治疗效果,延长患者生存时间,降低病死率。

Mortality analysis among HIV/AIDS cases in Huangshi,Hubei, 2000-2019

Objective By analyzing the mortality and related factors of HIV / AIDS patients in Huangshi city from 2000 to 2019, we explore the methods of reducing the mortality. Methods Downloading the relevant cards from China's AIDS Prevention and Control Comprehensive System, we analyze the database using excel 2007 and Spass21.0. Results Among the 2 361 HIV /AIDS cases, 760 cases died,the case fatality rate was 32.19%. 600 patients (78.95%) were over 50 years old at the time of death; 73.15% (556/760) patients had received CD4⁺T lymphocyte test, of which 65.11% (362/556) patients had detection value<200/μL; 50.79% (386/760) patients had received antiviral therapy; 54.61% (415/760) patients died within one year after diagnosis. Multivariate binomial Logistic regression analysis showed that other patients (OR=5.081, 95%CI=2.776-9.302), the patients who did not receive antiviral therapy (OR=4.716, 95%CI=3.002-7.407), the CD4⁺T lymphocyte value <200 /μL (OR=8.550, 95%CI=4.289-17.046) and the patients who did not detect lymphocyte (OR=29.392, 95%CI=13.466-64.155) were more likely to die within one year. The proportion of AIDS related death causes decreased year by year, reaching 39.13% in 2017. The average age of patients at the time of death increased from 37.39 years in 2001 to 66.86 years in 2019. Conclusion The cumulative mortality rate of HIV/AIDS in Huangshi City is higher than the national average, the average age at the time of death was higher than the national average, and the trend is increasing year by year. Late onset cases are more likely to die within one year after diagnosis. The coverage rate of antiretroviral treatment is increasing, and the proportion of non AIDS related deaths and the survival time of patients are increasing. We should continue to carry out early detection and treatment, improve the effect of antiviral therapy, prolong the survival time of patients and reduce the mortality.