淄博市2000—2021年HIV/AIDS患者生存时间及影响因素分析

Analysis of Survival and Its Related Factors of HIV/AIDS Patient in Zibo,2000—2021

目的探究淄博市2000年1月—2021年12月艾滋病病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immune deficiency syndrome,AIDS)患者生存时间及影响因素。方法采用回顾性分析对2000年1月—2021年12月淄博市HIV/AIDS患者的临床资料进行研究统计其生存情况,绘制生存曲线,并分析患者生存时间的影响因素。结果1203例HIV/AIDS患者纳入队列,全死因死亡147例(12.22%),平均生存时间(168.48±5.82)个月,第1、3、5、10年累计生存率分别为90.42%、88.01%、85.94%、80.58%。单因素分析结果显示,患者不同民族、婚姻状况、确定感染时的年龄、职业、文化程度、感染途径、样本来源、首次检测CD4^(+)T淋巴细胞计数、是否接受抗病毒治疗与生存时间有关(P<0.05);多因素分析结果显示,婚姻状况离异或丧偶[β=0.515,HR=1.673,95%CI 1.129~2.479]、未接受抗病毒治疗[β=2.088,HR=8.067,95%CI 4.176~15.582]是影响淄博市HIV/AIDS患者生存时间的独立危险因素(P<0.05),文化程度大专及以上[(β=-1.168,HR=0.311,95%CI 0.146~0.663)、文化程度不详(β=-2.417,HR=0.089,95%CI 0.012~0.686)、样本来源检测咨询(β=-0.946,HR=0.388,95%CI 0.242~0.624)、首次检测CD4^(+)T]淋巴细胞计数351~<500个/μL(β=-0.856,HR=0.425,95%CI 0.211~0.854)、首次检测CD4^(+)T淋巴细胞计数≥500个/μL(β=-0.948,HR=0.387,95%CI 0.173~0.865)是影响淄博市HIV/AIDS患者生存时间的保护性因素(P<0.05)。结论淄博市HIV/AIDS患者的生存率较高,HIV/AIDS患者生存时间受多种因素影响,应加强早发现和早治疗工作,延长HIV感染/AIDS患者生存时间,体现了《HIV/AIDS诊断标准和处理原则》的执行标准。

Objective The survival time and influencing factors of HIV/AIDS patients in Zibo city from January 2000 to December 2021 were analyzed to provide a scientific basis.Methods A retrospective cohort study was conducted to analyze HIV/AIDS patients in Zibo city from January 2000 to December 2021.Survival rates were described using the life table method,and survival curves were plotted using the Kaplan-Meier method.Factors influencing patient survival time were analyzed using the Cox proportional hazards regression model.Results 1203 HIV/AIDS cases were included in the cohort,with 147(12.22%)allcause deaths,a mean survival time of(168.48±5.82)months,and cumulative survival rates of 90.42%,88.01%,85.94%,and 80.58%at years 1,3,5,and 10,respectively.Univariate analysis revealed that patients with different ethnicities,marital status,age at the time of confirmed infection,occupation,educational level,infection route,sample source,CD4^(+)T lymphocyte count detected for the first time,receipt of antiviral treatment,and survival time were related(P<0.05).Multivariate analysis identified divorced or widowed marital status(β=0.515,HR=1.673,95%CI 1.129-2.479)and not receiving antiviral treatment(β=2.088,HR=8.067,95%CI 4.176-15.582)as independent risk factors affecting the survival time of HIV/AIDS patients in Zibo City.Education levels of college or above(β=-1.168,HR=0.311,95%CI 0.146-0.663)and unknown(β=-2.417,HR=0.089,95%CI 0.012-0.686),consulting on sample source testing(β=-0.946,HR=0.388,95%CI 0.242-0.624),first detection of CD4^(+)T lymphocyte count:351-<500 cells/μL(β=-0.856,HR=0.425,95%CI 0.211-0.854),and≥500 cells/μL(β=-0.948,HR=0.387,95%CI 0.173-0.865)were protective factors(P<0.05).Conclusion The survival rate of HIV/AIDS patients in Zibo is high.The survival time of HIV/AIDS patients is affected by many factors,and early detection and treatment efforts should be strengthened to prolong the survival time of HIV infection/AIDS patients.This reflects the implementation standards of the Diagnostic Standards and Management Principles for HIV/AIDS.