2005～2008年江苏省首次接受抗病毒治疗的艾滋病患者生存分析

Survival analysis of AIDS patients initially starting anti-retroviral therapy during 2005-2008 in Jiangsu province

目的:分析江苏省2005～2008年首次接受抗病毒治疗的艾滋病患者到2011年底的生存状况,探讨影响艾滋病抗病毒治疗患者生存时间的因素。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2005～2008年首次进入抗病毒治疗的艾滋病患者数据资料,采用Kaplan-Meier绘制研究对象的生存曲线,运用COX比例风险模型对江苏省艾滋病患者首次接受抗病毒治疗后的生存状况影响因素进行分析。结果:451例研究对象男女比例为1.75∶1,以已婚或同居为主,年龄多数在20～50岁之间,感染途径主要是异性性传播,患者以苏南经济发达地区为主;治疗前基线CD4+T细胞计数平均为107个/mm3,抗病毒治疗后第12、24、36、48、60个月的累计生存率分别为0.88、0.85、0.84、0.78和0.78,84例死亡病例中53.6%死于首次治疗后6个月内。多因素Cox回归分析显示,基线CD4+T细胞计数、首次抗病毒治疗方案,抗病毒治疗方案是否改变与其生存时间之间存在统计学关联。结论:艾滋病抗病毒治疗显著提高了艾滋病患者的生存率,早期治疗能提高治疗效果。

Objective：To analyze the survival rate of AIDS patients who initially received anti-retroviral therapy in 2005-2008 by the end of 2011, and to determine factors associated with survival status. Methods： Information of AIDS patients initially starting anti- retroviral therapy during 2005-2008 was collected from Chinese HIV/AIDS Integrated Control System. Kaplan-Meier was applied to make survival curve;and Cox proportional hazard regression model was used to determine associated factors of survival status. Results：Totally 451 cases were analyzed. The gender ratio of man to women was 1.75：1. Most of participants were married or cohabitated,with 20 to 50 years old. The major transmitted route was heterosexual. Most of participants were from southern area of Jiangsu. At baseline,average CD4＋ T cell counts were 107/mm3. Accumulative survival rates in 12th,24th,36th,48th and 60th after therapy were 0.88,0.85,0.84,0.78 and 0.78 respectively. 53.6% of participants died within the first six months of therapy. CD4＋ T cell counts at baseline,initial therapy schedule,and therapy schedule changed were found to be associated with survival time of patients. Coneluslon：Anti-retroviral therapy improved the survival rate of AIDS patients. Starting therapy earlier can get better treatment result.