新疆伊宁市2006-2015年HIV/AIDS患者生存状况分析

Survival of HIV/AIDS patients in Yining City,Xinjiang,2006-2015

目的分析新疆伊宁市2006-2015年艾滋病病毒(HIV)感染者和艾滋病(AIDS)患者的生存时间及其影响因素。方法运用回顾性队列研究方法,对2006-2015年中国艾滋病综合防治信息管理系统中报告的伊宁市6 437例HIV/AIDS患者数据资料进行分析,引用寿命法计算研究对象的生存率,采用Kaplan-Meier法和Cox比例风险模型分析研究对象生存时间的影响因素。结果 6 437例研究对象中,1 016例(15.8%)死于艾滋病相关疾病,接受抗病毒治疗3 687例(57.3%)。平均生存时间为100.0(98.9~101.1)个月,1、3、5、7、9年的生存率分别为93.0%、86.0%、82.0%、80.0%、78.0%。单因素分析结果显示,性别、年龄、民族、文化程度、感染途径、诊断时的病程、最近一次CD4^+T淋巴细胞检测结果,是否接受抗病毒治疗是生存时间的影响因素;多因素分析结果显示,诊断时年龄在45岁以下(与18~29岁相比:HR=0.339,95%CI:0.172~0.665;与30~岁相比:HR=0.800,95%CI:0.666~0.961)、诊断时病程为HIV感染阶段(HR=0.334,95%CI:0.270~0.412)、最近1次CD4^+T淋巴细胞检测结果≥350个/μl(HR=0.281,95%CI:0.222~0.356)可以降低艾滋病患者因艾滋病死亡的风险;未接受抗病毒治疗因艾滋病死亡的风险(HR=0.243,95%CI:0.204~0.290)高于接受抗病毒治疗的艾滋病患者。结论诊断时的年龄、所处的病程、CD4^+T淋巴细胞水平和是否接受抗病毒治疗影响艾滋病病毒感染者和艾滋病患者的生存时间;艾滋病患者应及早接受抗病毒治疗,可以延长生存时间。

Objective To analyze the survival time and its influencing factors in HIV/AIDS patients in Yining City, Xinjiang from 2006 to 2015. Methods A retrospective cohort study was conducted to analyze the information of 6,437 HIV/AIDS pa- tients reported by Chinese HIV/AIDS Comprehensive Prevention and Treatment Information Management System in Yining City, Xinjiang from 2006 to 2015. Life table method was applied to calculating the survival rate of the patients. Kaplan-Merier and Cox proportion hazard regression model were used to identify the factors affecting their survival time. Results Among the 6,437 patients, 1,016（ 15.8% ）died of AIDS-related diseases and 3,687（57.3%）received antiretroviral therapy. The average survival time was 100.0（98.9-101.1）months, and the 1-,3-, 3-, 5-, 7- and 9-year survival rates were 93.0%,86.0%, 82.0%, 80.0% and 78.0% respectively. Univariate analysis showed that gender, age, nationality, educational background, transmission route, AIDS phase, CD4^＋T cell count in the last testing and receiving antiretroviral therapy or not were the factors influencing their survival time. Multivariate Cox regression showed that confirming HIV/AIDS infection at the age of 45 years or below （as compared with 18 -29 years old ： HR = 0.339, 95% CI：0. 172-0.665 ; as compared with 30- years old ： HR = 0.800, 95% CI：0.666-0.961 ） , confir- ming HIV/AIDS infection in HIV infection stage （HR = 0.334, 95%CI：0.270-0.412） and CD4^＋T cell count in the last testing ≥350/μ1 （HR=0.281, 95%CI：0.222-0.356） could reduce the risk of AIDS-related death. The patients that did not receive an- tiretroviral therapy had a higher risk of AIDS-related death （ HR=0.243, 95%CI： 0.204-0.290） than those did. Conclusions The survival time of HIV-infected individuals and AIDS patients is influenced by their age of diagnosis with AIDS, HIV/AIDS phase, CD4^＋T cell count and whether or not received antiretroviral therapy. Earlier initiation of antiretroviral therapy in AIDS pa- tients can extend their survival time.