福建省HIV感染者/AIDS患者生存时间及影响因素分析

Analysis on the survival time and related factors among HIV/AIDS patients in Fujian province

目的探讨福建省HIV感染者/AIDS患者（HIV/AIDS患者）生存时间及影响因素。方法选择1987年1月1日至2014年12月31日福建省新报告的HIV/AIDS患者进入研究队列,收集HIV/AIDS患者全死因死亡相关信息,计算HIV/AIDS患者的全死因死亡率和生存率,应用单因素和多因素分析法探讨HIV/AIDS患者生存时间的影响因素。结果 1987-2014年福建省共有HIV/AIDS患者5 163例纳入研究,报告死亡849例,全死因死亡率6.60/100人年。HIV/AIDS患者最长的生存时间为21.38年,平均生存时间13.67年（95%CI：12.67~14.66）,中位生存时间为14.79年。1年生存率为88%,5年生存率为77%,10年生存率为61%。Cox比例风险模型分析显示,40~49岁年龄组、文盲、未接受高效抗病毒治疗、CD4＋T细胞计数〈200个/mm3的研究对象的全死因死亡率要分别高于15~39岁年龄组、高中或中专/大专及以上文化程度、接受抗病毒治疗和CD4＋T细胞计数≥200个/mm3。结论近年来,福建省HIV/AIDS患者全死因死亡率呈逐年下降趋势,可针对生存时间的影响因素进行持续有效的干预,扩大关怀服务的覆盖范围,以进一步改善HIV/AIDS患者的生存质量,减少死亡。

Objective To discuss the survival time and related factors among HIV/AIDS patients （HIV/ AIDS） in FuJian province. Methods Newly reported HIV/AIDS patients in Fujian province were recruited into cohort study between January 1, 1987 and December 31, 2014. Information related to the death of HIV/ AIDS patients was collected and death and survival rates were calculated. Univariate and multivariate analysis were used to analyze the influencing factors of survival time. Results A total of 5 163 HIV/AIDS patients were recruited and 849 deaths were reported with the mortality rate of 6.60 per 100 person per year. The aver- age survival time of HIV/AIDS patients was 13.67 years with the longest of 21.38 years （95~C1： 12.67~ 14.66） and the median of 14.79 years. The cumulative survival rates of 1, 5 and 10 year were 88~, 77~ and 61 ~/6o, respectively. Analysis of cox proportional hazard model indicated that the death rates of patients aged 40 to 49 years, with low education, not receiving highly effective anti-retroviral therapy, and CD4 T cell counts less than 200/mm3 were higher than those of 15 to 39 years old, with higher education background, having re- ceived highly effective anti-retroviral therapy, and CD4＋ T cell counts greater than or equal to 200/ram3. Conclusions The all-cause mortality rate of HIV/AIDS patients keeps going down in recent years, it is neces- sary to implement the effective interventions continuously based on the factors related to the mortality of HIV/ AIDS patients, expand the coverage of patients care and further improve the life quality of HIV/AIDS patients.