1997—2018年广州市白云区人免疫缺陷病毒感染及死亡相关风险因素分析

Analysis of Risk Factors Related to HIV Infection and Death in Baiyun District of Guangzhou from 1997 to 2018

目的:了解广州市白云区人免疫缺陷病毒感染者/艾滋病患者(HIV/AIDS患者)的人口学特征和行为学特征,判断其中存在的与患者感染和死亡相关的危险因素。方法:抽取1997—2018年广州市白云区HIV确诊病例组成专病队列,运用回顾性队列研究的方法,采用Cox回归模型分析影响患者生存的各种风险因素,利用寿命表法计算进行抗病毒治疗对患者生存率的影响,最后采用Kaplan-Meier绘制生存分析函数。结果:在纳入观察研究的2 718名患者中,发生与HIV相关的死亡例数为197人,平均死亡率为2.1/100人年。在Cox回归模型危险因素分析中,确诊年龄在40岁以上的死亡风险是20~40岁年龄组的2.57倍;文化程度为“初中及以下”的死亡风险是“高中及以上”的1.67倍;出生户籍为非广州市户籍患者死亡风险为广州市户籍患者的0.54倍;接受抗病毒治疗的患者死亡风险为未接受治疗组的0.04倍。根据寿命表显示,未接受治疗组的生存分析时间中位数为5.60年,接受治疗组的生存分析时间中位数为17.88年。结论:性别、年龄、出生户籍、抗病毒治疗等都是HIV/AIDS患者死亡的影响因素,在感染初期即进行抗病毒治疗能有效延长患者生存时间。

OBJECTIVE To examine the demographic characteristics and behavioral characteristics of HIV/AIDS patients in Baiyun district of Guangzhou, and to determine the possible risk factors associated with infection and death. METHODS A special disease cohort was selected from the confirmed cases of HIV in Baiyun district of Guangzhou from 1997 to 2018. The Cox regression model was used to analyze the various risk factors affecting the survival of patients. The life table method was used to calculate the antiviral treatment. The effect of survival rate was finally drawn by Kaplan-Meier. RESULTS Among the 2 718 patients enrolled in the observational study, the number of HIV-related deaths was 197, with an average mortality rate of 2.1/100 person-years. In the risk factor analysis of the Cox regression model, the risk of death at the age of 40 years and older(including 40 years old) was 2.57times that of the 20~40 age group;the risk of death with a “degree of junior high school and below” was “high school and above” 1.67 times;the risk of death for a non-Guangzhou household registration was 0.54 times that of a household registered in Guangzhou;the risk of death for patients receiving antiviral treatment was 0.04 times that of the untreated group. According to the life table data, the median survival analysis time of the untreated group was 5.60 years;the median survival analysis time of the treated group was 17.88 years. CONCLUSION Gender, age, birth registration, and antiviral therapy are all factors influencing the death of HIV/AIDS patients. Antiviral therapy in the early stage of infection can effectively prolong the survival time of patients.