陕西省安康市2002—2015年HIV/AIDS病例死亡情况及影响因素

Death situation of HIV/AIDS cases and influencing factors in Ankang,Shaanxi,2002-2015

目的分析安康市艾滋病病毒(HIV)感染者/艾滋病患者(AIDS)的死亡情况及其影响因素,探讨降低死亡的方法。方法依据《艾滋病和艾滋病病毒感染诊断标准》(WS293-2008)及2012年艾滋病综合防治信息系统新死因分类相关规定,采用Excel 2007和SPSS 20.0软件对2002—2015年安康市艾滋病死亡病例数据库资料进行整理和统计分析。结果累计427例HIV/AIDS病例中,死亡145例,累计病死率33.96%。其中男性69.0%(100/145),平均死亡年龄(37.83±10.75)岁,农民占62.8%(91/145),性传播占73.8%(107/145)。平均生存年限1.22年,确诊后1年内死亡比例为66.9%(97/145)。死亡病例接受抗病毒治疗比例30.3%(44/145);2004—2015年抗病毒治疗比例由35.7%上升到84.2%,同期HIV/AIDS病例的病死率由42.9%下降到6.9%。结论安康市青壮年男性外出务工农民感染者多,多数病例发现较晚、抗病毒治疗比例低,是导致死亡率高的主要原因。需有针对性的开展艾滋病宣传教育,进一步扩大检测,提高抗病毒治疗覆盖率,有效降低病死率。

Objective To analyze the death situation of HIV infected people and AIDS cases and influencing factors in Ankang City, and discuss the methods of reducing the mortality. Methods Based on ＂Diagnostic Criteria for HIV/AIDS＂ （WS293-2008） and the relevant regulations on classification of new death causes in 2012 AIDS comprehensive control information system, the death case database materials in Ankang City from 2002 to 2015 were collected and analyzed statistically by using Excel 2007 and SPSS 20.0 software. Results Among total 427 HIV/AIDS cases, there were 145 death cases, with the cumulative case fatality rate of 33,96%, Among the death cases, the males accounted for 69.0% （100/145）, and the average death age was （37.83＋ 10.75） years. Farmers accounted for 62.8% （91/145）, and the sexual transmission accounted for 73.8% （107/145）. The average survival limit was 1.22 years, and the death rate after the definite diagnosis was 66.9% （97/ 145）. The proportion of death cases receiving antiviral therapy was 30.3% （44/145）. The proportion of antiviral therapy increased from 35.7% to 84.2% during the period of 2004 to 2015, and HIV/AIDS case fatality rate in the same term decreased from 42.9% to 6.9%. Conclusion The young male migrant workers are the most of HIV/AIDS cases in Ankang City. The detection of most cases is late, and the antiviral therapy rate is low, which are the major causes of the high death rate. Therefore, it is necessary to carry out AIDS publicity education purposefully, further expand the detection, improve the coverage rate of antiviral therapy so as to effectively reduce the case fatality rate.