山东省临沂市新报告≥50岁HIV/AIDS病例生存时间及影响因素分析

Analysis on survival time and influencing factors of newly reported HIV/AIDS cases aged 50 years and above in Linyi city

目的分析山东省临沂市新报告≥50岁的艾滋病病毒感染者和艾滋病患者(HIV/AIDS)生存状况及其影响因素,为提高患者生存时间和优化防控措施提供依据。方法采用回顾性队列研究方法,通过中国疾病预防控制信息系统艾滋病防治综合信息系统,收集截至2022年12月31日现住址在山东省临沂市的确诊时年龄≥50岁的HIV/AIDS病例,采用寿命表法描述生存状况,Cox比例风险模型分析生存时间的影响因素。结果共350例HIV/AIDS病例纳入分析,其中HIV感染者210例(占60.00%)、AIDS患者140例(占40.00%)。接受抗病毒治疗300例(85.71%)。截至观察终点,存活265例,死亡85例,确诊阳性后第1、3、5、10年的累积生存率分别为78.04%、70.84%、64.04%、57.79%。多因素Cox回归分析结果显示,已婚有配偶(HR=0.478,95%CI:0.268~0.850,P<0.05)、初中学历(HR=0.344,95%CI:0.161~0.733,P<0.05)、已接受抗病毒治疗(HR=0.142,95%CI:0.066~0.308,P<0.05)和首次CD4细胞计数200~349个/μL(HR=0.381,95%CI:0.185~0.784,P<0.05)、首次CD4细胞计数350~499个/μL(HR=0.227,95%CI:0.092~0.561,P<0.05)、首次CD4细胞计数≥500个/μL(HR=0.359,95%CI:0.143~0.901,P<0.05)的病例死亡风险相对较低。结论临沂市≥50岁HIV/AIDS病例的生存率有待提高,婚姻状况、文化程度、是否接受抗病毒治疗和首次CD4细胞计数是该人群生存时间的影响因素。

Objective To analyze the survival time and influencing factors of newly reported HIV/AIDS cases aged 50 years and above in Linyi city,so as to provide evidence for improve the survival time and optimize the prevention and control measures.Methods A retrospective cohort study was conducted to analyze the data of HIV/AIDS cases who lived in Linyi city aged 50 years and above before December 31th,2022.Data was collected from Chinese HIV/AIDS Basic Information Management System.Life table method was applied to describe the survival status,and influencing factors of survival time were analyzed by Cox proportional regression model.Results Of the 350 HIV/AIDS cases,210 were HIV(60.00%)and 300 received antiretroviral therapy(ART).At the end point of observation,265 cases were survived and 85 cases were died.The cumulative survival rate of 1 year,3 years,5 years and 10 years after diagnosis was 78.04%,70.84%,64.04% and 57.79%.Cox multivariate analysis showed that those married(HR=0.478,95%CI:0.268-0.850,P<0.05),with junior middle school education level(HR=0.344,95%CI:0.161-0.733,P<0.05),received ART(HR=0.142,95%CI:0.066-0.308,P<0.05),and the first CD4^(+)T cell counts in 200-349(HR=0.381,95%CI:0.185-0.784,P<0.05),350-499(HR=0.227,95%CI:0.092-0.561,P<0.05)and≥500 cells/μL(HR=0.359,95%CI:0.143-0.901,P<0.05)could reduce the risk of death.Conclusion Survival of HIV/AIDS cases≥50 years of age in Linyi city needs to be improved,with marital status,literacy,receipt of antiretroviral therapy,and first CD4 cell counts as influencing factors for survival time in this population.