赣州市2006—2018年艾滋病抗病毒治疗患者生存及影响因素研究

Study on survival status and its influencing factors of AIDS patients taking antiviral therapy in Ganzhou city from 2006 to 2018

目的了解赣州市艾滋病抗病毒治疗患者生存状况和影响因素,为防治工作提供科学依据。方法采用回顾性调查方法,收集赣州市2006—2018年艾滋病抗病毒治疗患者基础数据,采用生存分析方法,对研究对象生存状况及其影响因素进行分析。结果共纳入研究对象2 062例,死亡226例,总病死率3.6/100人年。因艾滋病相关死亡占73.90%,其中治疗后12个月内死亡占64.07%,生存时间中位数为6个月,平均生存时间为133.27个月,治疗1、5、13年累计生存率分别为94.00%、87.00%、81.00%。COX回归分析发现,性别为女性(HR=0.62,95.0%CI:0.41~0.94)、文化程度为高中及以上(HR=0.39,95.0%CI:0.23~0.66)、首次治疗时CD4+T淋巴细胞计数≥200/μl(HR=0.35,95.0%CI:0.24~0.51)是患者生存保护因素,年龄≥40岁(HR=1.68,95.0%CI:1.17~2.43)和首次治疗时有机会性感染/肿瘤(HR=3.67,95.0%CI:2.65~5.08)是患者生存危险因素,差异均有统计学意义(P值均<0.05)。结论赣州市免费艾滋病抗病毒治疗患者早期生存率相对较低,应促进HIV感染者早发现、早治疗,加大随访管理、依从性教育。

Objective To understand the survival status and its influencing factors of AIDS patients taking antiviral therapy in Ganzhou city from 2006 to 2018;to provide scientific evidence for AIDS antiviral treatment.Methods Basic information was collected for AIDS patients taking antiviral therapy in Ganzhou city from 2006 to 2018,which was analyzed by retrospective survey method.Survival time and its influencing factors were analyzed by survival analysis.Results A total of 2 062 subjects were included in the study,among whom 226 died,resulting total mortality rate of 3.6/100 person-years.A total of 73.90%death were related to AIDS,among whom 64.07%died within 12 months after treatment,and the median survival time was 6 months.The average survival time was 133.27 months.The cumulative survival rates at 1,5,and 13 years were 94.00%,87.00%,and 81.00%,respectively.COX regression analysis found that female patient(HR=0.62,95.0% CI:0.41-0.94),high school degree(HR=0.39,95.0% CI:0.23-0.66)or above and baseline CD4+T lymphocyte count≥200/μl(HR=0.35,95.0% CI:0.24-0.51)were protective factors for survival,while patients starting treatment at age≥40 years(HR=1.68,95.0% CI:1.17-2.43)and opportunistic infections/tumors(HR=3.67,95.0% CI:2.65-5.08)were survival risk factors,all with statistical difference(all P<0.05).Conclusion The early survival rate of AIDS patients taking antiviral therapy in Ganzhou city is relatively low.Promoting early detection and early treatment of HIV-infected patients,strengthening the education of follow-up management compliance and follow-up management are the key focus of antiviral therapy.