Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
J Korean Med Sci. 2013 Jul;28(7):990-7. doi: 10.3346/jkms.2013.28.7.990. Epub 2013 Jul 3.
A retrospective study was conducted to determine the mortality, causes and risk factors for death among HIV-infected patients receiving antiretroviral therapy (ART) in Korea. The outcomes were determined by time periods, during the first year of ART and during 1-5 yr after ART initiation, respectively. Patients lost to follow-up were traced to ascertain survival status. Among 327 patients initiating ART during 1998-2006, 68 patients (20.8%) died during 5-yr follow-up periods. Mortality rate per 100 person-years was 8.69 (95% confidence interval, 5.68-12.73) during the first year of ART, which was higher than 4.13 (95% confidence interval, 2.98-5.59) during 1-5 yr after ART. Tuberculosis was the most common cause of death in both periods (30.8% within the first year of ART and 16.7% during 1-5 yr after ART). During the first year of ART, clinical category B and C at ART initiation, and underlying malignancy were significant risk factors for mortality. Between 1 and 5 yr after ART initiation, CD4 cell count ≤ 50 cells/µL at ART initiation, hepatitis B virus co-infection, and visit constancy ≤ 50% were significant risk factors for death. This suggests that different strategies to reduce mortality according to the time period after ART initiation are needed.
一项回顾性研究旨在确定在韩国接受抗逆转录病毒疗法（ART）的 HIV 感染患者的死亡率、死因和死亡风险因素。结果分别通过 ART 的第一年和开始 ART 后 1-5 年来确定。对失访患者进行了追踪，以确定其生存状况。在 1998 年至 2006 年间开始接受 ART 的 327 名患者中，有 68 名（20.8%）在 5 年随访期间死亡。每 100 人年的死亡率为 8.69（95%置信区间，5.68-12.73），高于开始 ART 后 1-5 年的 4.13（95%置信区间，2.98-5.59）。结核病是两个时期死亡的最常见原因（ART 开始后的第一年为 30.8%，开始 ART 后 1-5 年为 16.7%）。在开始 ART 的第一年，临床分类 B 和 C 以及潜在恶性肿瘤是死亡的重要风险因素。在开始 ART 后 1-5 年内，CD4 细胞计数≤50 个/µL、乙型肝炎病毒合并感染和就诊次数≤50%是死亡的重要风险因素。这表明，需要根据开始 ART 后的时间段制定不同的降低死亡率的策略。
