遵义市HIV/AIDS患者死亡率及其影响因素研究

Study on the Mortality and Risk Factors Among HIV/AIDS in Zunyi City

目的分析遵义市1995-2014年HIV/AIDS患者死亡率及其影响因素。方法以1995-2014年报告的所有现住址为遵义市的HIV/AIDS患者为研究对象,收集病例的死亡相关资料,计算死亡率,并应用Cox回归模型分析死亡率的影响因素。结果遵义市共报告HIV/AIDS患者2 748例,死亡620例(22.56%),年龄中位数为39岁,男性占71.77%,农民占35.91%,已婚有配偶者占49.84%,45.00%为初中文化程度。研究对象累计观察6 584.84人年,死亡率为9.48/100人年。2004年死亡率达到29.66/100人年,2005年后总体呈下降趋势。HIV/AIDS患者接受抗病毒治疗比例从2006年的0.60%增加到2014年的36.64%,随着治疗比例的增加,死亡率逐渐降低至2014年的7.75/100人年。多因素分析显示感染途径、基线CD4^+T淋巴细胞水平、是否接受抗病毒治疗是死亡率的影响因素。结论抗病毒治疗有效降低了遵义市HIV/AIDS患者的死亡率,但今后仍需继续扩大监测和抗病毒治疗覆盖面,以降低HIV/AIDS患者的死亡风险。影响因素主要有感染途径、是否抗病毒治疗、是否检测CD4^+T淋巴细胞。

Objective To analyze the mortality and risk factors among HIV/AIDS in Zunyi city from 1995 - 2014. Methods All HIV/AIDS with residential address in the Zunyi city from 1995 -2014 were included in this study. The mortality rate was calculated. Cox regression model was used to analyze the impact factors of mortality. Results The 620 of 2 748 died （22. 56% ）. The median age of death was 39 years. Male accounted for 71.77%. 35.91% were farmers. Married accounted for 49. 84%. 45.00% had education level of middle school. The number of cumulative observation was 6 584. 84 persons per year. Annual mortality rate was 9.48%. Annual mortality rate reached 29.66% in 2004 and declined afterward. The proportion of HIV/AIDS receiving antiretroviral treatment increased from 0. 60% in 2006 to 36. 64% in 2014. With the increase in the proportion of treatment, the mortality rate was gradually decreased to 7.75% in 2014. Multiple factor analysis showed that the infection route, baseline CD4^ ＋T lymphocyte counts, and whether receiving antiviral therapy were the influencing factors of mortality. Conclusion Antiviral therapy effectively reduces the mortality rate of HIV/AIDS in Zunyi. Continuations of monitoring and wide deployment of antiviral therapy are required to further reduce the mortality of HIV/AIDS. The main influencing factors are infection route, usage of antiretroviral therapy, and baseline of CD4 ^＋T lymphocyte counts.