1999-2011年岑溪市艾滋病感染者及病人生存分析

Survival Analysis of HIV-infected Individuals and AIDS Patients in Cenxi from 1999 to 2011

目的了解1999-2011年广西岑溪市HIV/AIDS的生存情况及其影响因素。方法采用回顾性研究,对1999-2011年岑溪市报告的所有现住址为本地的HIV/AIDS为研究对象,收集生存、诊疗、死亡信息,采用Cox比例风险回归模型影响艾滋病感染者及病人生存时间的因素进行分析。结果共收集408例HIV/AIDS的流行病学信息,研究对象累计观察947.96人年,艾滋病相关疾病死亡104例,死亡率10.97/100人年。1999-2008年10年间的死亡率整体呈上升趋势,自2009年起逐年下降。研究对象报告确认HIV感染至观察截止时间的中位生存时间7.56年,接受过抗病毒治疗者的中位生存时间9.00年,未接受过抗病毒治疗者的中位生存时间7.01年,二者差异有统计学意义(P<0.05)。Cox多因素分析显示年龄、性别、艾滋病临床分期特征是影响死亡的密切因素。结论抗病毒治疗有利于提高艾滋病患者的生存率;当地HAART覆盖率低,多数艾滋病感染者在发病后才开始HAART,今后应进一步强化健康教育力度,动员更多的HIV感染者及早接受HAART治疗。

Objective To investigate the survival situation of HIV-infected individuals and AIDS patients and its influencing factors in Cenxi,Guangxi during the period of 1999-2011.Methods All HIV-infected individuals and AIDS patients with local residency reported in Cenxi from 1999 to 2011 were enrolled in this study.The survival,clinical and death information was collected and retrospectively studied.Multiple regression analysis under Cox proportional hazard model was conducted to examine the risk factors for deaths.Results The epidemic information of 408 HIV-infected individuals and AIDS patients was collected.All the individuals and patients were followed-up for a total of 947.96 person-years,and 104 patients died,with overall mortality rate as 10.97/100 person-years.The mortality rate had been increasing from 1999 to 2008,but decreasing since 2009.The median survival time since the identification of HIV infection was 7.56 years overall,and was 9.00 years for those receiving antiretroviral treatment and 7.01 years for those without antiretroviral treatment.The difference between the groups was statistically significant（P0.05）.Data from multiple regression analysis indicated that age,gender and AIDS clinical stage were significantly associated with death among HIV-infected patients.Conclusions Antiretroviral treatment had significantly improved the survival of AIDS patients.At the same time,the local HAART coverage was low.The majority of HIV-infected people have no awareness of proper treatment to protect themselves until the symptoms appear serious.Therefore,the related health education should be strengthened in the future,and the relevant medical professionals should urge the HIV-infected people to accept HAART treatment earlier.