嘉兴市HIV/AIDS病人生存时间及影响因素分析

Survival time of HIV/AIDS patients and influencing factors in Jiaxing

目的了解嘉兴市艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的生存时间和影响因素。方法采用回顾性队列研究的方法,对2007-2017年报告现住址为嘉兴市的HIV/AIDS病人的相关资料进行分析,通过寿命表法计算生存率,运用Kaplan-Meier法和COX比例风险模型分析生存时间的影响因素。结果 1 455例HIV/AIDS病人的平均生存时间为10.02年[95%可信区间(CI):9.838~10.210],1、5、10年生存率分别为95.63%、91.93%和88.24%。多因素分析显示,≥50岁年龄组死亡风险较<50岁年龄组高[P<0.001,风险比(HR)=3.979,95%CI=2.551~6.207)];异性性传播和其他途径感染的病人死亡风险(P=0.008,HR=2.325,95%CI:1.242~4.350;P=0.002,HR=5.154,95%CI:1.787~14.867)较同性性传播者高;确诊时首次检测CD4+T淋巴细胞数≥350个/mm3和接受抗病毒治疗(ART)的病人死亡风险(P<0.001,HR=0.074,95%CI:0.034~1.161;P<0.001,HR=0.103,95%CI:0.067~0.157)均较低。结论应采取扩大检测的防治策略,早期发现HIV/AIDS病人,并及时开展抗病毒治疗,从而降低病人死亡的风险,延长生存时间。

Objective To understand the survival time and influencing factors of HIV/AIDS patients in Jiaxing.Methods A retrospective cohort study was conducted to analyze the data of HIV/AIDS patients living in Jiaxing from 2007 to 2017.Influencing factors of survival time were investigated by Kaplan-Meier method and COX proportional hazards model.Results The 1455 HIV/AIDS patients had an average survival time of 10.02 years(95%CI=9.838-10.210).The cumulative survival rates of the cases in the first 1,5 and 10 years were 95.63%,91.93%and88.24%respectively.Multivariate Cox regression analysis showed the death risk in the≥50 age group was higher than in the<50 age group(P<0.001,HR=3.979,95%CI=2.551-6.207).Patients with heterosexual and other transmissions had a higher risk of death than those with homosexual way(P=0.008,HR=2.325,95%CI=1.242-4.350;P=0.002,HR=5.154,95%CI=1.787-14.867).Patients with baseline CD4+T lymphocyte count≥350/mm3 and antiretroviral therapy(ART)had a lower death risk.Conclusion Expanded HIV detection and HARRT strategy should be used widely in early diagnosis and therapy,which can reduce the death risk and prolong survival time of HIV/AIDS patients.