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[2008年至2015年河南省15岁及以上艾滋病患者生存状况的回顾性队列研究]

[A retrospective cohort study on survival status of AIDS patients among 15 or above-year-olds in Henan province, from 2008 to 2015].

作者信息

Yang W J, Li N, Liang Y, Li J, Fan P Y, Sun D Y, Zhu Q, Wang Z

机构信息

Institute for AIDS/STD Prevention and Cure, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Feb 10;38(2):173-178. doi: 10.3760/cma.j.issn.0254-6450.2017.02.008.

Abstract

To explore the survival status and affecting factors among patients diagnosed as AIDS, in Henan province. Database of AIDS patients were downloaded from the China information system for disease prevention and control-AIDS with a retrospective study conducted. Inclusion criteria on patients would involve those diagnosed between 2008 and 2015, aged 15 years or above. A total number of 25 525 HIV/AIDS patients were enrolled in this study. During the follow-up period, the overall mortality among all the patients was 24.9%. Mortality of those having received the highly active antiretroviral treatment (HAART) was 14.4%. Proportion for the treatment coverage increased gradually, from 72.1% in 2008 to 92.8% in 2015. The overall mortality rate dropped from 21.2% to 4.1% and the mortality of those having received HAART patients dropped from 9.2% to 2.6%. Results from the multiple factors analysis showed that factors as: CD(4)(+) T cell count (CD(4)) <50 cell/μl when the AIDS diagnosis was made (adjusted =2.45) were related to higher risk on mortality among HIV/AIDS patients. Patients having received HAART (adjusted =0.13) had lower risks on mortality. Among patients having received treatment, results from the multiple factors analysis showed that factor as TMP-SMZ dosage being administered (adjusted =0.76) were related to low mortality risk. As for CD(4) counts of the patients, the adjusted s were 1.26 in 50-cells/μl group and 1.97 in the <50 cells/μl group, respectively when the diagnosis was made. Both groups had high risk on mortality patients with lower baseline CD(4) counts (adjusted were 1.44, 1.84 in 50-cells/μl and <50 cells/μl groups, respectively) seemed to have higher risk on mortality. Antiretroviral therapy appeared an important factor that affecting the survival of HIV/AIDS patients. CD(4) count test, early identifying and treating the AIDS patients together with providing TMP-SMZ prevention and treatment programs, were important approaches in extending the survival time so as to reduce the death rates from AIDS related illnesses.

摘要

为探究河南省艾滋病确诊患者的生存状况及影响因素,从中国疾病预防控制信息系统艾滋病数据库中下载数据并进行回顾性研究。患者纳入标准为2008年至2015年间确诊、年龄15岁及以上。本研究共纳入25525例HIV/AIDS患者。随访期间,所有患者的总死亡率为24.9%。接受高效抗逆转录病毒治疗(HAART)患者的死亡率为14.4%。治疗覆盖率逐渐上升,从2008年的72.1%升至2015年的92.8%。总死亡率从21.2%降至4.1%,接受HAART治疗患者的死亡率从9.2%降至2.6%。多因素分析结果显示,确诊艾滋病时CD4(+)T细胞计数(CD4)<50个细胞/μl(校正值=2.45)等因素与HIV/AIDS患者较高的死亡风险相关。接受HAART治疗的患者(校正值=0.13)死亡风险较低。在接受治疗的患者中,多因素分析结果显示,服用复方磺胺甲恶唑(TMP-SMZ)剂量(校正值=0.76)等因素与低死亡风险相关。对于患者的CD4计数,确诊时50个细胞/μl组和<50个细胞/μl组的校正值分别为1.26和1.97。两组基线CD4计数较低的患者死亡风险均较高(50个细胞/μl组和<50个细胞/μl组的校正值分别为1.44和1.84)。抗逆转录病毒治疗似乎是影响HIV/AIDS患者生存的重要因素。CD4计数检测、早期识别和治疗艾滋病患者以及提供TMP-SMZ预防和治疗方案,是延长生存时间从而降低艾滋病相关疾病死亡率的重要途径。

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