[1995年至2012年四川省凉山州艾滋病患者的生存分析]

[Survival analysis of AIDS patients in Liangshan prefecture, Sichuan province from 1995 to 2012].

作者信息

Gong Yuhan, Wang Qixing, Liao Qiang, Yu Gang, Yin Bibo, Nan Lei, Bian Shaoyong, Wang Ke, Wang Ju, Li Yangya, Zhang Guang

机构信息

Liangshan Prefectural Center for Disease Control and Prevention, Xichang 615000, China.

Email:

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Aug;48(8):678-83.

PMID:25388462

Abstract

OBJECTIVE

To analyze the survival time and its related factors among AIDS patients in Liangshan prefecture of Sichuan province from 1995 to 2012.

METHODS

A retrospective cohort study was conducted to analyze the information of 5 263 AIDS patients. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Kaplan-Meier and Cox proportion hazard regression model were used to identify the factors related to survival time.

RESULTS

Among 5 273 AIDS patients, 819 (15.6%)died of AIDS related diseases; 2 782(52.9%) received antiretroviral therapy. The average survival time was 126.7 (117.1-136.2) months, and the survival rate in 1, 5, 10, 15 years were 95.4%, 78.8%, 54.2%, and 31.8% respectively. Univariate analysis showed a significant difference in survival time of age diagnosed as AIDS patients, nationality, transmission route, AIDS phase, CD4(+)T cell counts in the last testing, receiving antiretroviral therapy or not. Multivariate Cox regression showed age diagnosed AIDS below 50 years old ( < 15 years old:HR = 0.141, 95%CI:0.036-0.551;15-49 years old:HR = 0.343, 95%CI:0.241-0.489), HIV infection diagnosed phase (HR = 0.554, 95%CI:0.432-0.709), CD4(+)T cell counts last testing ≥ 350/µl (HR = 0.347, 95%CI:0.274-0.439) reduced the risk of dying of AIDS related diseases among AIDS patients. The patients having not received antiretroviral therapy had a higher risk of death(HR = 3.478, 95%CI:2.943-4.112) compared to those who received antiretroviral therapy.

CONCLUSION

Survival time of AIDS patients was possibly mainly influenced by the age of diagnosed as AIDS patients, AIDS phase, CD4(+)T cell counts and whether or not received antiretroviral therapy. The early initiation of antiretroviral therapy could extend the survival time.

摘要

目的

分析1995年至2012年四川省凉山州艾滋病患者的生存时间及其相关因素。

方法

采用回顾性队列研究分析5263例艾滋病患者的信息。数据来源于中国艾滋病综合信息管理系统。应用寿命表法计算生存比例，采用Kaplan-Meier法和Cox比例风险回归模型识别与生存时间相关的因素。

结果

在5273例艾滋病患者中，819例（15.6%）死于艾滋病相关疾病；2782例（52.9%）接受了抗逆转录病毒治疗。平均生存时间为126.7（117.1 - 136.2）个月，1年、5年、10年、15年的生存率分别为95.4%、78.8%、54.2%和31.8%。单因素分析显示，艾滋病确诊患者的年龄、民族、传播途径、艾滋病分期、最后一次检测时的CD4(+)T细胞计数、是否接受抗逆转录病毒治疗等因素在生存时间上存在显著差异。多因素Cox回归显示，确诊艾滋病时年龄小于50岁（<15岁：HR = 0.141，95%CI：0.036 - 0.551；15 - 49岁：HR = 0.343，95%CI：0.241 - 0.489）、HIV感染确诊分期（HR = 0.554，95%CI：0.432 - 0.709）、最后一次检测时CD4(+)T细胞计数≥350/µl（HR = 0.347，95%CI：0.274 - 0.439）可降低艾滋病患者死于艾滋病相关疾病的风险。未接受抗逆转录病毒治疗的患者与接受抗逆转录病毒治疗的患者相比，死亡风险更高（HR = 3.478，95%CI：2.943 - 4.112）。