桂林市1996—2019年HIV/AIDS患者生存时间影响因素分析

Analysis of Factors Influencing the Survival Time of HIV/AIDS Patients in Guilin,1996-2019

目的探讨桂林市HIV/AIDS患者生存时间及其影响因素,为延长HIV/AIDS患者生存时间提供理论依据。方法采用回顾性队列研究方法,运用Kaplan-Meier法、Log-Rank法、加速失效时间模型(AFT模型)对桂林市1996-2019年HIV/AIDS患者生存时间及其影响因素进行分析。结果桂林HIV/AIDS患者死亡率8.61/100人年,中位生存时间12.70年(95%CI:12.10~13.90),1、3、5、10年累积生存率分别为79.44%、70.43%、64.00%和55.33%。多因素AFT模型分析显示,性别为男性,确证时年龄组为0~14岁、25~50岁,≥50岁,样本来源于其他就诊者咨询,受血(制品)前检测者生存时间较短。民族为壮族,受教育程度越高,传播途径为同性性传播、注射吸毒、性接触+注射毒品、输血/血制品传播,职业为家政/待业、其他和不详,接受过抗病毒治疗,首次检测CD4+T淋巴细胞水平越高者生存时间越长。结论性别、民族、文化程度、传播途径、职业、确证时年龄、是否接受抗病毒治疗、首次CD4+T淋巴细胞水平、样本来源均为生存时间的影响因素。应加大农村及建筑工地预防艾滋病的宣传教育,提倡早检测,早治疗。研究针对男性、≥50岁年龄组人群、农民/民工、低文化程度、首次检测CD4+T淋巴细胞水平低的HIV/AIDS患者的宣传管理治疗措施,有助于改善其预后,延长其生存时间。

Objective To study the survival time of HIV/AIDS patients and its influencing factors in Guilin and provide a theoretical basis for improving the survival time of HIV/AIDS patients.Methods A retrospective cohort study was conducted.Kaplan-Meier method,Log-Rank method,and accelerated time to failure model(AFT model)were used to analyze the survival time and influencing factors of HIV/AIDS patients in Guilin from 1996 to 2019.Results The mortality rate of HIV/AIDS patients in Guilin was 8.61/100 person-years,the median survival time was 12.70 years(95%CI:12.10-13.90),and the 1,3,5,and 10-year cumulative survival rates were 79.44%,70.43%,64.00%and 55.33%,respectively.Multivariate AFT model analysis showed that males,the age group at the time of confirmation was 0-14 years old,25-50 years old,≥50 years old,the patients sources from“other patients”who visited the hospital to treat disease other than HIV/AID and test before receiving blood(products)had shorter survival time.The ethnic was Zhuang;The higher the education level,the transmission routes were same-sex sexual transmission,injection drug use,sexual contact+injection drug use,blood transfusion/blood product transmission;Occupation were housekeeping/unemployed,other and unknown;Received antiviral treatment;The higher the first CD4 level had the longer the survival time.Conclusion Gender,ethnicity,education level,route of transmission,occupation,age at the time of confirmation,whether or not antiviral therapy was received,CD4 level at first time,and sample source are all factors influencing survival time.The publicity and education on AIDS prevention in rural areas and construction sites should be increased,and early detection and treatment should be advocated.Publicity management and treatment measures for male,farmer/rural migrant workers,≥50 years old,low education level,and patients with low CD4 level for the first time should be studied to improve their prognosis and prolong their survival time.Received antiviral treatment Gender,ethnicity,education level,route of transmission,occupation,age at the time of confirmation,whether or not antiviral therapy was received,CD4 level at first time,and sample source are all factors influencing survival time.The publicity and education on AIDS prevention in rural areas and construction sites should be increased,and early detection and treatment should be advocated.Publicity management and treatment measures for male,farmer/rural migrant workers,≥50 years old,low education level,and patients with low CD4 level for the first time should be studied to improve their prognosis and prolong their survival time.