河北省1989-2013年HIV/AIDS死亡与HAART关系的分析

Effect of highly active anti-retroviral therapy on reducing HIV/AIDS related death in Hebei,1989-2013

目的 了解河北省HIV/AIDS的HAART效果.方法 以1989-2013年全省报告的4 148例HIV/AIDS进行研究,对发现的HIWAIDS定期随访、检测CD4＋T淋巴细胞计数、登记死亡.自2003年开始,对符合HAART条件的HIV/AIDS实施免费治疗.观察截止日期为2013年12月31日.结果 4 148例HIV/AIDS,观察12 451.48人年,全死因死亡968例,死亡密度7.77/100人年,其中接受HAART者死亡密度为2.87/100人年,未接受HAART者死亡密度为16.58/100人年,后者是前者的5.77倍.对1 894例AIDS,自发病之日至观察截止日,观察4 774.48人年,全死因死亡581例,死亡密度121.69/100人年,其中参加HAART者死亡密度4.77/100人年,未参加HAART者死亡密度125.92/100人年.CD4＋T淋巴细胞计数＜200 cells/mm^3组的死亡密度由不接受HAART治疗的22.9/100人年降至接受HAART治疗的5.3/100人年.通过年度分析发现,随着HIV/AIDS人群HAART覆盖率逐年提高,人群的全死因死亡率逐年下降.HIV人群HAART覆盖率提高,可降低未参加HAART的HIV感染者的死亡率.结论 进一步扩大抗病毒治疗覆盖面,可有效减少HIV/AIDS的死亡.

Objective To investigate the effect of highly active anti-retroviral therapy （HAART） on reducing HIV/AIDS related death.Methods The analysis was conducted by using the data of 4 148 HIV/AIDS cases reported in Hebei province from 1989 to 2013.Regular follow-up,CD4 detection,registration of death were carried out for them.Free HAART has been provided to people living with HIV/AIDS who met the treatment requirement since 2003.Results Of 4 148 HIV/AIDS cases,12 451.48 person years were observed,968 cases died due to all registered death causes.The death density was 7.77/100 person years.The death density was 2.87/100 person years for the HIV/AIDS cases receiving HAART,and 16.58/100 for the HIV/AIDS cases receiving no HAART.In 1 894 AIDS cases,a total of 4 774.48 person years were observed from onset to death,581 cases died due to all registered death causes,and the death density was 121.69/100 person years.The death density was 4.77/100 person years for the cases receiving HAART,and 125.92/100 person years for the cases receiving no HAART.In the cases with CD less than 200/mm^3,the death density was 22.9/ 100 person years for those receiving no HAART and 5.3/100 person years for those receiving HAART.The annual analysis found that the death rate due to all registered death causes declined as the increase of HAART coverage in people living with HIV/AIDS.The expanding of HAART coverage in people infected with HIV can reduce death rate among them.Conclusion Further expanding of HAART can effectively reduce the death among people living with HIV/AIDS.