Poorolajal J, Hooshmand E, Mahjub H, Esmailnasab N, Jenabi E
Research Centre for Health Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Public Health. 2016 Oct;139:3-12. doi: 10.1016/j.puhe.2016.05.004. Epub 2016 Jun 24.
The life expectancy of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) reported by several epidemiological studies is inconsistent. This meta-analysis was conducted to estimate the survival rate from HIV diagnosis to AIDS onset and from AIDS onset to death.
The electronic databases PubMed, Web of Science and Scopus were searched to February 2016. In addition, the reference lists of included studies were checked to identify further references, and the database of the International AIDS Society was also searched. Cohort studies addressing the survival rate in patients diagnosed with HIV/AIDS were included in this meta-analysis. The outcomes of interest were the survival rate of patients diagnosed with HIV progressing to AIDS, and the survival rate of patients with AIDS dying from AIDS-related causes with or without highly active antiretroviral therapy (HAART). The survival rate (P) was estimated with 95% confidence intervals based on random-effects models.
In total, 27,862 references were identified, and 57 studies involving 294,662 participants were included in this meta-analysis. Two, 4-, 6-, 8-, 10- and 12-year survival probabilities of progression from HIV diagnosis to AIDS onset were estimated to be 82%, 72%, 64%, 57%, 26% and 19%, respectively. Two, 4-, 6-, 8- and 10-year survival probabilities of progression from AIDS onset to AIDS-related death in patients who received HAART were estimated to be 87%, 86%, 78%, 78%, and 61%, respectively, and 2-, 4- and 6-year survival probabilities of progression from AIDS onset to AIDS-related death in patients who did not receive HAART were estimated to be 48%, 26% and 18%, respectively. Evidence of considerable heterogeneity was found. The majority of the studies had a moderate to high risk of bias.
The majority of HIV-positive patients progress to AIDS within the first decade of diagnosis. Most patients who receive HAART will survive for >10 years after the onset of AIDS, whereas the majority of the patients who do not receive HAART die within 2 years of the onset of AIDS.
多项流行病学研究报告的人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）患者的预期寿命并不一致。本荟萃分析旨在估计从HIV诊断到AIDS发病以及从AIDS发病到死亡的生存率。
检索电子数据库PubMed、科学网和Scopus至2016年2月。此外，检查纳入研究的参考文献列表以识别更多参考文献，并检索国际艾滋病协会的数据库。本荟萃分析纳入了探讨HIV/AIDS诊断患者生存率的队列研究。感兴趣的结果是诊断为HIV的患者进展为AIDS的生存率，以及接受或未接受高效抗逆转录病毒治疗（HAART）的AIDS患者死于AIDS相关原因的生存率。根据随机效应模型估计生存率（P）及其95%置信区间。
共识别出27,862篇参考文献，本荟萃分析纳入了57项研究，涉及294,662名参与者。从HIV诊断到AIDS发病的2年、4年、6年、8年、10年和12年生存概率估计分别为82%、72%、64%、57%、26%和19%。接受HAART的患者从AIDS发病到AIDS相关死亡的2年、4年、6年、8年和10年生存概率估计分别为87%、86%、78%、78%和61%，未接受HAART的患者从AIDS发病到AIDS相关死亡的2年、4年和6年生存概率估计分别为48%、26%和18%。发现存在相当大的异质性证据。大多数研究存在中度至高度偏倚风险。
大多数HIV阳性患者在诊断后的第一个十年内进展为AIDS。大多数接受HAART的患者在AIDS发病后将存活超过10年，而大多数未接受HAART的患者在AIDS发病后2年内死亡。
