Yang Yue-Cheng, Duan Song, Xiang Li-Fen, Ye Run-Hua, Gong Yu-Rong, Yang Shi-Jiang, Gao Jie, Yang Zhong-Ju, Han Wen-Xiang, Li Zhou-Lin, Pu Yong-Cheng, Yang Jian-Hua, Cao Dong-Dong, Li Wei-Mei, He Na
Dehong Center for Disease Control and Prevention, Mangshi 678400, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Oct;33(10):1026-30.
To examine the mortality and risk factors among HIV-infected patients during 1989 - 2011 in Dehong prefecture, Yunnan province.
All HIV-infected patients reported during 1989 - 2011 in Dehong prefecture who held local residency were included in the study. Mortality rates and cumulative survival rates were calculated. Multiple regression analysis under Cox proportional hazard model was conducted to examine the risk factors for deaths.
A total of 13 006 HIV-infected patients were included in this study including 73.2% males, 79.1% peasants and 48.7% married at the time of reporting. 64.5% of the patients were ethnic minorities, and 68.7% were illiterate or having received only primary school education. All the patients were followed-up for a total of 55 962.30 person-years with 4648 patients died, with overall mortality rate as 8.31/100 person-years. The mortality rate had been increasing from 1990 to 2004 but decreasing since 2005. The average survival time since the identification of HIV infection was 9.48 years overall, and was 16.65 years for those having received antiretroviral treatment (ART) and 7.67 years for those without ART. Data from multiple regression analysis indicated that ART and socio-demographic characteristics such as age, gender, ethnicity, occupation, marital status, education background etc. were significantly associated with death among HIV-infected patients.
The comprehensive AIDS campaigns including ART had significantly reduced the deaths among HIV-infected patients in Dehong prefecture. More efforts on the scaling up program of ART as well as the enhanced management and follow-up program tailored for HIV-infected patients with different socio-demographic characteristics were needed to further reduce the deaths in the area.
调查1989年至2011年期间云南省德宏州HIV感染患者的死亡率及危险因素。
纳入1989年至2011年期间德宏州报告的所有具有当地户籍的HIV感染患者。计算死亡率和累积生存率。采用Cox比例风险模型进行多元回归分析,以探讨死亡的危险因素。
本研究共纳入13006例HIV感染患者,其中男性占73.2%,农民占79.1%,报告时已婚者占48.7%。64.5%的患者为少数民族,68.7%为文盲或仅接受过小学教育。所有患者共随访55562.30人年,4648例患者死亡,总死亡率为8.31/100人年。死亡率在1990年至2004年期间呈上升趋势,但自2005年以来呈下降趋势。自确诊HIV感染以来的平均生存时间总体为9.48年,接受抗逆转录病毒治疗(ART)者为16.65年,未接受ART者为7.67年。多元回归分析数据表明,ART以及年龄、性别、民族、职业、婚姻状况、教育背景等社会人口学特征与HIV感染患者的死亡显著相关。
包括ART在内的综合艾滋病防治活动显著降低了德宏州HIV感染患者的死亡率。需要进一步加大ART扩大治疗项目的力度,并针对具有不同社会人口学特征的HIV感染患者加强管理和随访项目,以进一步降低该地区的死亡率。