British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, Vancouver, Canada.
AIDS Res Ther. 2011 Sep 5;8:31. doi: 10.1186/1742-6405-8-31.
We examined trends in AIDS-defining illnesses (ADIs) among individuals receiving highly active antiretroviral therapy (HAART) in British Columbia (BC), Canada to determine whether declines in ADIs could be contributing to previously observed improvements in life-expectancy among HAART patients in BC since 1996.
HAART-naïve individuals aged ≥ 18 years who initiated treatment in BC each of the following time-periods 1996 - 1998; 1999 - 2001; 2002 - 2004; 2005 - 2007 were included. The proportion of participants with reported ADIs were examined for each time period and trends were analyzed using the Cochran-Armitage Trend Test. Cox proportional hazards models were used to examine factors associated with ADIs.
A total of 3721 individuals (81% male) initiated HAART during the study period. A total of 251 reports of ADIs were received from 214 unique patients. These occurred in a median of 4 months (IQR = 1-19 months) from HAART initiation. The proportion of individuals with a reported ADI did not change significantly from 4.6% in the earliest time period to 5.8% in the latest period (p = 0.181 for test of trend). There were no significant declines in any specific ADI over the study period. Multivariable Cox models found that individuals initiating HAART during 2002-04 were at an increased risk of ADIs (AHR = 1.55; 95% CI 1.04-2.32) in comparison to 1996 - 98, but there were no significant differences in other time periods.
Trends in reported ADIs among individuals receiving HAART since 1996 in BC do not appear to parallel improvements in life-expectancy over the same period.
我们研究了在加拿大不列颠哥伦比亚省（BC）接受高效抗逆转录病毒治疗（HAART）的个体中艾滋病定义疾病（ADIs）的趋势，以确定自 1996 年以来，BC 中 HAART 患者的预期寿命提高是否可以归因于 ADIs 的减少。
纳入了在以下每个时间段内在 BC 开始治疗的年龄≥18 岁的 HAART 初治个体：1996-1998 年；1999-2001 年；2002-2004 年；2005-2007 年。每个时间段报告的 ADI 患者比例进行了检查，并使用 Cochran-Armitage 趋势检验分析了趋势。使用 Cox 比例风险模型检查了与 ADIs 相关的因素。
研究期间共有 3721 人（81%为男性）开始接受 HAART。从 214 名患者中收到了 251 份 ADI 报告。这些报告发生在 HAART 开始后中位数为 4 个月（IQR=1-19 个月）。从最早的时间段的 4.6%到最新时间段的 5.8%，报告有 ADI 的个体比例没有显著变化（趋势检验 p=0.181）。在研究期间，没有任何特定的 ADI 显著减少。多变量 Cox 模型发现，与 1996-98 年相比，2002-04 年开始 HAART 的个体发生 ADIs 的风险增加（AHR=1.55；95%CI 1.04-2.32），但在其他时间段没有显著差异。
自 1996 年以来，BC 中接受 HAART 的个体报告的 ADI 趋势似乎与同期预期寿命的提高不一致。
