Zhang Guang, Gong Yuhan, Wang Qixing, Zhang Shize, Liao Qiang, Yu Gang, Wang Ke, Wang Ju, Ye Shaodong, Liu Zhongfu
Exchange and Communication Office of National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China.
Division of HIV/AIDS Control and Prevetion, Liangshan Yi Autonomous Prefecture Center for Disease Control and Prevention, Sichuan province, Xichang 615000, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Nov;49(11):967-72.
To investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province.
A retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System. Cox proportion hazard regression model was used to identify impact factors related survival time.
Among 8 310 ART AIDS patients who initially received ART, their mean age was (34.59 ± 9.10) years old, 65.50% (5 443 cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68 ± 21.69) months. 436 cases died of AIDS related diseases, 28.67% (125 cases) of them died within the first 6 months of treatment. The cumulative survival rate of receiving ART in 1, 2, 3, 4 5 years were 97.11%, 93.41%, 90.61%, 88.81%, 86.02%, respectively. Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR = 1.57, 95% CI: 1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR = 1.64, 95% CI: 1.20-2.24), before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR = 1.53, 95% CI: 1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases (HR = 1.80, 95% CI: 1.39-2.34). The patients with baseline CD4 (+) T lymphocytes cell counts < 50/µl (HR = 9.79, 95% CI: 6.03-15.89), 50-199/µl (HR = 3.26, 95% CI: 2.32-4.59), 200-349/µl (HR = 1.69, 95% CI: 1.22-2.34), were at a higher risk death than those with CD4 (+) T lymphocytes cell counts ≥ 350/µl.
Accumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province. AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4 (+) T lymphocyte count have higher risk of death.
探讨四川省凉山彝族自治州首次接受抗逆转录病毒治疗（ART）的艾滋病患者的生存时间及其影响因素。
采用回顾性队列研究，分析2005 - 2013年期间凉山彝族自治州首次接受ART的18岁以上艾滋病患者的信息，这些信息来自中国艾滋病抗病毒治疗数据传真信息系统。采用Cox比例风险回归模型确定与生存时间相关的影响因素。
在8310例首次接受ART的艾滋病患者中，平均年龄为（34.59±9.10）岁，65.50%（5443例）通过注射吸毒感染HIV，从HIV检测阳性到开始ART的平均时间为（24.68±21.69）个月。436例死于艾滋病相关疾病，其中28.67%（125例）在治疗的前6个月内死亡。接受ART的1、2、3、4、5年累积生存率分别为97.11%、93.41%、90.61%、88.81%、86.02%。多因素Cox回归分析显示，接受ART的男性患者死于艾滋病相关疾病的风险高于女性（HR = 1.57，95%CI：1.13 - 2.182），通过注射吸毒感染HIV的患者死于艾滋病相关疾病的风险高于通过异性传播感染的患者（HR = 1.64，95%CI：1.20 - 2.24），治疗前1年内患有结核病的患者死亡风险高于未患结核病的患者（HR = 1.53，95%CI：1.05 - 2.21），在治疗的前3个月出现艾滋病相关疾病或症状的艾滋病患者死亡风险高于未患这些疾病的患者（HR = 1.80，95%CI：1.39 - 2.34）。基线CD4（+）T淋巴细胞计数<50/μl（HR = 9.79，95%CI：6.03 - 15.89）、50 - 199/μl（HR = 3.26，95%CI：2.32 - 4.59）、200 - 349/μl（HR = 1.69，95%CI：1.22 - 2.34）的患者死亡风险高于CD4（+）T淋巴细胞计数≥350/μl的患者。
四川省凉山彝族自治州艾滋病患者首次接受抗逆转录病毒治疗后累积生存率较高。男性艾滋病患者、近1年患有结核病、通过静脉吸毒途径感染HIV、在ART前3个月内患有艾滋病相关疾病或症状、基线CD4（+）T淋巴细胞计数较低者死亡风险较高。
