1990―2019年中国老年人群HIV/AIDS疾病负担及其变化趋势

Disease burden and trend of HIV/AIDs among the elderly in China during 1990-2019

目的分析1990―2019年我国老年人群HIV/AIDS的感染、新发感染、死亡以及伤残调整生命年(disability-adjusted life years,DALYs)率的变化情况。方法利用全球疾病负担研究(Globe Burden of Disease Study 2019,GBD 2019)数据,根据年龄、性别、年份对疾病负担指标进行统计描述,并利用Joinpoint回归模型进行时间趋势分析,计算感染、新发感染、死亡和DALYs率的年度变化百分比(annual percentage change,APC)和平均年度变化百分比(average annual percentage change,AAPC)。结果1990―2019年中国老年人群HIV/AIDS的标化感染率从7.56/10^(5)增至48.90/10^(5);标化新发感染率从1.03/10^(5)增至1.89/10^(5);标化死亡率从0.35/10^(5)增至2.97/10^(5);标化DALYs率从11.01/10^(5)增至90.51/10^(5)。根据Joinpoint回归模型结果显示,1990―2019年,中国老年人群HIV/AIDS标化感染率、标化新发感染率、标化死亡率和标化DALYs率整体呈上升趋势,AAPC分别为6.71%、1.91%、7.65%和7.52%,差异均有统计学意义(均有P<0.05)。结论中国老年人群HIV/AIDS的疾病负担严重,各项疾病负担指标总体呈上升趋势。应加强HIV/AIDS的早期筛查与健康教育,根据老年人群HIV/AIDS的疾病负担特点,制定有针对性地预防措施。

Objective To describe and analyze the prevalence,morbidity rate,mortality rate,and disability-adjusted life years(DALYs)rate of HIV/AIDS among the elderly in China from 1990 to 2019.Methods Data was collected from the Global Burden of Disease Study 2019(GBD 2019).Statistical description was used to analyze disease burden indicators by age,gender,and year.Temporal trend analysis was conducted by Joinpoint regression models.Annual percentage change(APC)and average annual percentage change(AAPC)were calculated for prevalence,morbidity rate,mortality rate,and DALYs rate.Results From 1990 to 2019,the age-standardized prevalence of HIV/AIDS among the elderly in China increased from 7.56/10^(5) to 48.90/10^(5).The age-standardized morbidity rate increased from 1.03/10^(5) to 1.89/10^(5).The age-standardized mortality rate increased from 0.35/10^(5) to 2.97/10^(5).The DALYs rate increased from 11.01/10^(5) to 90.51/10^(5).According to the Joinpoint results,from 1990-2019,there was an overall increasing trend in the standardized prevalence,mortality rate,morbidity rate,DALYs rate of HIV/AIDS among the elderly in China,with AAPC of 6.71%,1.91%,7.65%,and 7.52%respectively.The differences were all statistically significant with P<0.05.Conclusions The disease burden of HIV/AIDS among the elderly in China is still severe.The disease burden index is on the rise.Early HIV/AIDS screening and health education should be strengthened,and targeted preventive measures should be formulated according to the HIV/AIDS burden characteristics among the elderly.