Dray-Spira Rosemary, Gueguen Alice, Persoz Anne, Deveau Christiane, Lert France, Delfraissy Jean-François, Meyer Laurence
INSERM U687-IFR69, Hôpital National de Saint-Maurice, Saint-Maurice Cedex, France.
J Acquir Immune Defic Syndr. 2005 Oct 1;40(2):190-7. doi: 10.1097/01.qai.0000165908.12333.4e.
To estimate the independent association between socioeconomic conditions and the risk of all-cause hospitalization or death during the course of HIV disease in the highly active antiretroviral therapy (HAART) era.
Patients in the French PRIMO multicenter prospective cohort of 319 individuals were enrolled during primary HIV-1 infection between 1996 and 2002. Associations between social characteristics (ie, employment status, stable partnership) and the risk of hospitalization or death were assessed using generalized estimating equations.
During a median follow-up of 2.5 years, 109 hospitalizations among 84 patients (26.3%) and 3 deaths occurred. Even after adjustment for classic determinants of HIV-infected patients' health status, social characteristics were independently associated with the risk of hospitalization or death, with a significantly increased risk for patients with temporary employment compared with those with stable employment (adjusted odds ratio [OR] = 2.5, 95% confidence interval: 1.1 to 5.6) and for patients without a stable partnership compared with those with a stable partnership (OR = 1.6, 95% confidence interval: 1.0 to 2.7).
In the era of HAART, adverse social conditions constitute independent risk factors of hospitalization or death during the course of HIV disease.
评估在高效抗逆转录病毒治疗(HAART)时代,社会经济状况与HIV疾病进程中全因住院或死亡风险之间的独立关联。
法国PRIMO多中心前瞻性队列研究纳入了319例患者,这些患者于1996年至2002年期间在初次感染HIV-1时入组。使用广义估计方程评估社会特征(即就业状况、稳定伴侣关系)与住院或死亡风险之间的关联。
在中位随访2.5年期间,84例患者(26.3%)发生了109次住院,并有3例死亡。即使在对HIV感染患者健康状况的经典决定因素进行调整后,社会特征仍与住院或死亡风险独立相关,与稳定就业的患者相比,临时就业患者的风险显著增加(调整后的优势比[OR]=2.5,95%置信区间:1.1至5.6),与有稳定伴侣关系的患者相比,无稳定伴侣关系的患者风险增加(OR=1.6,95%置信区间:1.0至2.7)。
在HAART时代,不良社会状况是HIV疾病进程中住院或死亡的独立危险因素。