2005—2019年伊犁州抗病毒治疗吸毒人群HIV/AIDS病例生存分析

Survival analysis of HIV/AIDS patients with antiretroviral therapy among drug users in Yili Prefecture from 2005 to 2019

目的分析2005—2019年新疆维吾尔自治区伊犁州接受抗病毒治疗(HAART)的吸毒人群HIV/AIDS病例生存情况及影响因素,为降低艾滋病死亡率提供依据。方法通过艾滋病抗病毒治疗信息系统收集2005—2019年伊犁州HAART治疗吸毒人群HIV/AIDS病例的人口学信息、临床分期、基线CD4+T淋巴细胞(CD4细胞)水平和治疗情况等资料,采用寿命表法估计生存率,采用Cox比例风险回归模型分析生存时间的影响因素。结果 2005—2019年共纳入HIV/AIDS病例1 935例,初始HAART治疗年龄中位数为37岁,CD4细胞中位数为293个/μL。第1、5、7和10年累积生存率分别为97%、78%、73%和66%。多因素Cox比例风险回归分析结果显示,体质指数(BMI)为18.5~<28.0 kg/m2(HR:0.391~0.656,95%CI:0.234~0.958)、基线CD4细胞水平>200个/μL (HR:0.354~0.667,95%CI:0.232~0.841)、近7 d未漏服药物(HR=0.009,95%CI:0.001~0.061)的HIV/AIDS病例死亡风险较低;WHO临床分期为Ⅱ~Ⅳ期(HR:1.479~2.311,95%CI:1.004~3.288)、治疗延迟时间≥1年(HR:1.287~1.388,95%CI:1.029~1.826)的HIV/AIDS病例死亡风险较高。结论伊犁州HAART治疗吸毒人群HIV/AIDS病例5年累积生存率为78%;BMI、基线CD4细胞水平、WHO临床分期、治疗延迟时间、近7 d漏服药物是其生存时间的影响因素。

Objective To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy(HAART)among drug users in Yili Prefecture,Xinjiang from 2005 to 2019,so as to provide references for reducing AIDS mortality.Methods The demographic information,clinical stage,baseline CD4~+T lymphocyte(CD4)level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System.The survival rate was calculated by the life table method.The influencing factors for survival time were analyzed by Cox proportional hazard regression model.Results Totally1935 patients were recruited,the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL.The cumulative survival rates at 1,5,7 and 10 years were 97%,78%,73%,and 66%,respectively.The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m~2(HR:0.391-0.656,95%CI:0.234-0.958),baseline CD4>200/μL(HR:0.354-0.667,95%CI:0.232-0.841),or missed medication in the last 7 days(HR=0.009,95%CI:0.001-0.061)had lower risk of death;the patients with WHO clinical stage ofⅡ-Ⅳ(HR:1.479-2.311,95%CI:1.004-3.288)or treatment delay≥1 years(HR:1.287-1.388,95%CI:1.029-1.826)had higher risk of death.Conclusion sThe 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%.Body mass index,baseline CD4 level,WHO clinical stage,treatment delay and missed medication in last 7 days were the influencing factors for survival time.