云南省大理州50岁及以上HIV/AIDS患者生存状况分析

Analysis of survival status of HIV/AIDS patients over 50 years old in Dali Prefecture

背景云南省大理州1997年首次报告50岁及以上人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者(简称HIV/AIDS患者),2010年以后50岁及以上HIV/AIDS患者报告数呈现明显上升趋势。2017年公布的《中国遏制与防治艾滋病“十三五”行动计划》中,已正式将老年人作为艾滋病防治的重点人群之一。目的分析大理州50岁及以上HIV/AIDS患者的生存状况。方法对1997-2018年报告的50岁及以上HIV/AIDS患者,运用寿命表法计算生存率,运用Cox回归分析生存的影响因素。结果大理州2019例50岁及以上HIV/AIDS患者的中位生存时间为8.33年(95%CI:7.75~9.33)。寿命表法分析结果显示确诊后1年、5年、10年的生存率分别为74.76%、56.26%、40.29%。Cox回归分析结果显示50岁及以上HIV/AIDS患者男性死亡风险是女性的1.74倍(95%CI:1.43~2.12);未抗病毒治疗患者的死亡风险是抗病毒治疗患者的9.32倍(95%CI:7.86~11.05);2010年以后报告患者死亡风险是2010年及以前报告患者的0.62倍(95%CI:0.52~0.74)。结论应加强对50岁及以上中老年人群的艾滋病防治工作,早检测、早发现、早治疗是此类人群艾滋病防治的重点措施。

Background HIV/AIDS patients aged 50 years and above are first reported in Dali prefecture in 1997,and the number of HIV/AIDS patients aged 50 years and above shows an obvious upward trend after 2010.In China's 13th Five-Year Action Plan for HIV/AIDS prevention and control released in 2017,the elderly have been officially identified as one of the key groups in HIV/AIDS prevention and control.Objective To analyze the survival status of HIV/AIDS patients aged over 50 years in Dali Prefecture.Methods Life table method was applied to analyze the survival rate of HIV/AIDS patients over 50 years from 1997 to 2018.Cox regression was used to analyze the influencing factors of survival time.Results The median survival time of 2019 HIV/AIDS patients was 8.33 years(95%CI:7.75-9.33).Life table analysis showed that the 1-year,5-year and 10-year survival rates were 74.76%,56.26%and 40.29%,respectively.Cox regression analysis showed that men over 50 years old were 1.74 times(95%CI:1.43-2.12)more likely to die of HIV/AIDS than women,while patients without antiviral treatment were 9.32 times(95%CI:7.86-11.05)more likely to die of HIV/AIDS.The risk of death after 2010 was 0.62 times(95%CI:0.52-0.74)of that before 2010.Conclusion It is necessary to strengthen the prevention and treatment of AIDS among the middle-aged and elderly people aged 50 years and above.Early detection and treatment are the key measures for AIDS prevention and treatment.