2003～2013年开封市艾滋病抗病毒治疗患者生存分析

Survival analysis of AIDS antiretroviral therapy in Kaifeng city during 2003～2013

目的了解开封市艾滋病患者接受抗病毒治疗后的生存状况及影响生存时间的因素。方法利用国家艾滋病抗病毒治疗信息系统,收集2003年1月至2013年12月在开封市接受艾滋病抗病毒治疗患者的基线和随访信息,采用COX比例风险模型对影响患者抗病毒治疗后生存时间的因素进行分析。结果共纳入3 365例艾滋病患者,其中存活患者2 607例,因艾滋病相关疾病死亡患者758例。研究对象1a^11a的累积生存率从94.22%下降到71.25%。多因素COX回归分析显示影响艾滋病患者生存时间的危险因素是男性(HR=1.308,95CI:1.128~1.517)、开始抗病毒治疗时年龄越大(HR=1.270,95CI:1.126~1.433)、初始治疗采用含DDI的方案(HR=2.342,95CI:1.848~2.969);影响艾滋病患者生存时间的保护因素是教育程度越高(HR=0.602,95CI:0.509~0.712)、基线CD4+T淋巴细胞计数越高(HR=0.543,95CI:0.499~0.591)。结论开封市艾滋病患者接受抗病毒治疗后生存率较高,对符合治疗条件的艾滋病患者尽早开展抗病毒治疗,进一步优化抗病毒治疗方案等延长开封市艾滋病患者生存时间的有效措施。

Objective To study the effect of national free highly active antiretroviral treatment（HAART）on reduction of mortality and relevant risk factors among adult Acquired immunodeficiency syndrome（AIDS）patients in Kaifeng city.Methods The data of AIDS patients on survival and death were collected from national HAART reporting system between 2003 and 2013,the COX proportional hazards model was applied to analyze the factors affecting the survival time of patients.Results Total 3 365 cases were selected.The cumulative survival rate in 1to11 fell to 94.22% from 71.25%.Multivariate COX proportional hazards regression analysis indicated that male（HR=1.308,95CI：1.128~1.517）,the greater age（HR=1.270,95CI：1.126~1.433）,initial therapy schedule including DDI（HR=2.342,95CI：1.848~2.969）are all risk to death（P 〈0.05）.On the contrary,the higher the level of education（HR=0.602,95CI：0.509~0.712）and baseline CD4＋T cell counts are helpful to survival（P 〈0.05）.Conclusion The national free treatment program has significantly improved the survival rate in Kaifeng city.Earlier initiation of antiretroviral treatment,combined with the better therapy schedule,would also help to achieve a higher survival rate among HIV/AIDS patients.