2002—2020年衢州市HIV感染者/艾滋病患者生存时间及其影响因素分析

Analysis of the survival time of and its influencing factors among HIV/AIDS cases in Quzhou City from 2002 to 2020

目的分析2002—2020年衢州市人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者/艾滋病(acquired immunodeficiency syndrome, AIDS)患者生存时间及其影响因素,为完善艾滋病防治策略提供依据。方法 从艾滋病综合防治数据信息管理系统中导出2020年现住址为衢州市的HIV感染者/艾滋病患者的基本情况、随访治疗管理等信息。采用Kaplan-Meier法估计生存率,应用Logrank法检验生存率曲线分布是否相同,Cox比例风险模型分析HIV感染者/艾滋病患者生存时间的影响因素。结果2002—2020年衢州市确诊的HIV感染者/艾滋病患者共有1 384例,死亡181例,病死率为13.08%;纳入研究对象的中位生存时间为212.65个月,抗病毒治疗(antiviral therapy,ART)的患者中位生存时间为(213.12个月)明显高于未经过ART患者(62.84个月),生存率曲线分布差异有统计学意义(χ^(2)=490.786, P=0.001);Cox比例风险模型分析发现,年龄、首次CD4^(+)T淋巴(CD4^(+)T细胞)细胞水平、是否ART是生存时间的影响因素。结论年龄小、 ART、发现时的CD4^(+)T细胞水平高能降低HIV感染者/艾滋病患者的死亡风险,早诊断早治疗有助于延长患者的生存时间。

Objective To analyze the epidemiological characteristics and survival time of human immunodeficiency virus(HIV)-infected/acquired immunodeficiency syndrome(AIDS)patients in Quzhou City from 2002 to 2020,and to investigate the influencing factors of survival,so as to provide scientific evidence for improving AIDS prevention and treatment strategies.Methods The basic information,follow-up treatment and management data of HIV-infected/AIDS patients living in Quzhou City in 2020 were derived from the"AIDS Comprehensive Prevention and Control Data Information Management System".Kaplan-Meier method was used to estimate the survival rate,Log-rank test to compare the survival distributions,and Cox proportional hazards model to analyze the influencing factors of survival time of HIV-infected/AIDS patients.Results From 2002 to 2020,there were 1384 diagnozed HIV-infected/AIDS cases whose residence address was in Quzhou City at the time of data analysis.Among those 181 died,resulting in a fatality rate of 13.08%.The median survival time of the included participants was 203.62 months,which was statistically significantly longer in those receiving antiretroviral treatment(ART)compared with those having not had received ART(213.12 months vs.62.84months,χ^(2)=490.786,P=0.001).Cox proportional hazards model analysis found that age,baseline CD4^(+)T lymphocyte level,and ART were the influencing factors of survival time.Conclusions Younger age,receiving ART,and high levels of CD4^(+)T lymphocytes at the time of diagnosis may be associated with reduced risk of death in HIV-infected/AIDS cases.Early diagnosis and treatment can help prolong the survival time of patients.