深圳市龙岗区HIV感染者/AIDS患者死亡情况及影响因素研究

Mortality and influencing factors among people living with HIV and AIDS in Longgang District,Shenzhen

目的了解深圳市龙岗区艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS患者)的死亡情况,并分析其相关影响因素。方法通过中国疾病预防控制艾滋病综合防治信息系统,选取2010年1月1日至2018年12月31日现住址为深圳市龙岗区的HIV/AIDS患者,按照病例入选标准确定研究对象;应用多因素Cox比例风险模型分析影响死亡的相关因素。结果本研究共选取590例HIV/AIDS患者,死亡236例(男性187例,女性49例)。多因素Cox回归分析结果显示,在婚、离异或丧偶者发生死亡的风险分别是未婚者的0.003倍和0.418倍;确诊时为AIDS患者的死亡风险是HIV感染者的9.149倍;异性传播、同性传播和采供血的死亡风险分别是注射吸毒的0.319、0.079和0.004倍;未接受CD4检测者的死亡风险是接受CD4检测者的9.166倍;接受抗病毒治疗者的死亡风险是未接受抗病毒治疗者的0.052倍。结论深圳市龙岗区HIV/AIDS患者死亡情况受多种因素影响,接受CD4检测和进行抗病毒治疗能明显降低HIV/AIDS患者死亡风险。提倡早期发现、早期诊断、进一步扩大CD4检测和抗病毒治疗的覆盖面,并加强追踪随访和管理,以降低HIV/AIDS患者死亡率,提高其生存质量。

Objective To understand the death status of people living with HIV/AIDS and analyze the related influencing factors in Longgang District,Shenzhen.Methods HIV/AIDS patients with current residential address in Longgang District,Shenzhen City from January 1,2010 to December 31,2018 were selected through the China information system for HIV/AIDS comprehensive prevention and control.Cox proportional hazard model was used to analyze the factors influencing the death on HIV/AIDS cases.Results A total of 590 HIV/AIDS cases were chosen,including 236 deaths(187 males and 49 females).Multi-factor Cox regression analysis showed that the risk of death in married,divorced or widowed persons was 0.003 time and 0.418 time that in unmarried persons;the mortality risk of AIDS patients at diagnosis was9.149 times that of HIV-infected persons;the risk of death from heterosexual transmission,homosexual transmission,and blood collection and supply was 0.319,0.079,and 0.004 times that of injecting drug use,respectively;the risk of death in those who were not tested for CD4 was 9.166 times that in those who were tested;the risk of death in patients receiving antiviral therapy was 0.052 time that in patients without antiviral therapy.Conclusion The mortality of HIV/AIDS cases in Longgang District,Shenzhen City was affected by many factors.Of them,CD4 testing and antiretroviral therapy could effectively reduce the risk of mortality among HIV/AIDS cases.