四川省凉山州1995-2012年HIV/AIDS病人死亡情况分析

An analysis on death and related factors among HIV/AIDS patients in Liangshan Prefecture of Sichuan during 1995-2012

目的了解凉山州1995-2012年艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的死亡情况及主要影响因素。方法利用中国艾滋病综合防治信息管理系统,对1995-2012年凉山州报告的28394例HIV/AIDS病人的数据资料进行描述性分析,应用寿命表法计算生存率、死亡率,采用Kaplan-Meier法分析HIV/AIDS病人生存时间的影响因素。结果累计死亡4075人(14.4%),其中因艾滋病及相关疾病死亡1494人(36.7%),吸毒过量死亡1001人(24.6%),其他原因死亡1457人(35.8%)。因艾滋病死亡的1494例HIV/AIDS病人中,诊断时平均年龄为(31.0±9.7)岁,男性1199人(80.3%),已婚有配偶970人(64.9%),彝族1398人(93.6%),经注射吸毒感染915人(61.2%),未接受抗病毒治疗1311人(87.8%),诊断到死亡平均时间为(28.9±24.1)个月。研究对象平均生存时间为166.97个月[95%可信区间(CI)=159.58~174.36]。1年生存率为98.42%,5年生存率为89.43%,10年生存率为76.39%,15年生存率为65.59%。总病死率为2.11/100人年。单因素分析结果显示,诊断时的年龄、民族、婚姻状况、职业、感染途径、病程阶段、是否接受抗病毒治疗,是HIV/AIDS病人生存时间的影响因素。结论凉山州HIV/AIDS病人因艾滋病死亡主要集中在农村,青年彝族男性为多;早期发现,及时接受抗病毒治疗可减少死亡。

Objective To understand the death and related factors in HIV/AIDS patients in Liangshan Prefecture from 1995 to 2012. Methods Descriptive analysis was performed in data of 28,394 HIV/AIDS patients in Liangshan Prefecture collected from Chinese HIV/AIDS Comprehensive Information Management System from 1995 to 2012. Life table was applied to calculate survival rate and mortality, and Kaplan-Meier was used to analyze impact factors related survival time in HIV/AIDS patients. Results There were 4075 cases of cumulative death （14.3%）, among which 1494（36.7%） died of AIDS related diseases, 1001 （24.6%） died of drug overdose, and 1457（35.8%） died of other causes. Among the patients died of AIDS related diseases, their average age at time of diagnosis was （31.0±9.7） years old, men accounted for 80.3% （1199）, the married accounted for 65.0% （970）, Yi Nationality accounted for 94.5%（1398）, the patients infected by injection drug use accounted for 61.2%（915）, and those not receiving antiretroviral therapy accounted for 87.8 % （1311）. The period from diagnosed HIV infection to death was （28.9±24.1） months. The average survival time was 166.97 （95 % CI = 159.58-- 174.36） months. The survival rate at 1 year,5 years,10 years and 15 years were 98.42%, 89. 43% ,76.39% and 65.59%, respectively. The total mortality was 2.11/100 personyears. Univariate analysis showed that age at time of diagnosis, nationality, marital status, occupation, transmission route, stage of HIV/AIDS disease, and whether or not receiving antiretroviral therapy were factors influencing survival time of HIV/AIDS patients. Cond^ions The HIV/AIDS patients dying of AIDS re- lated diseases mainly from rural areas, especially from young men of Yi nationality, in Liangshan Prefecture. Early diagnosis and timely initiation of antiretroviral thera- py can reduce the death.