Chen Y, Song X T, Yao Y M, Huang L, An Z, Yuan J, Xiong B, Liu Y H, Zhang Y Q
Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Jul 10;40(7):765-769. doi: 10.3760/cma.j.issn.0254-6450.2019.07.006.
To understand the mortality and influencing factors on injecting drug users (IDUs) with HIV/AIDS, in Guizhou province, 1996-2015. A retrospective cohort study was conducted on IDUs with HIV/AIDS that were reported through national comprehensive HIV/AIDS information system, in Guizhou province during 1996-2015. Cox proportional hazard regression model was used to analyze the influencing factors on the mortality of HIV/AIDS. A total of 3 958 cases of IDUs with HIV/AIDS were recruited in this study, with all-cause mortality rate of 44.01 (1 742/3 958) and total mortality rate of 7.80/100 person-years, respectively. The median survival time between diagnosis and death was 8.08 years. Mortality rate was 3.57/100 person-years in the group receiving antiretroviral therapy (ART). The mortality appeared to be 4.08/100 person-years in the group who were on methadone maintenance treatment (MMT). Data from the multiple regression analysis indicated that factors of gender, ethnicity, age when HIV/AIDS diagnosis was made, CD(4)(+)T lymphocyte (CD(4)) count at the first testing, ART and MMT were significantly associated with deaths among these people. The risk of death in females was 0.82 times (95: 0.69-0.98) higher than that in males. The risk of deaths among the ethnic minority subjects was 1.39 times (95: 1.21-1.60) higher than that of the Hans. The risk of death appeared to be 2.44 times higher (95: 1.07-5.56) in the over-50-year of age group than in the <20 year-old group, when HIV/AIDS was diagnosed for the first time. The risk of death in CD(4) ≥500/μl group in the first time was 0.27 times (95: 0.22-0.32) more than CD(4) <200/μl group in the firs time. The risk of death in cases who were treated with ART or MMT was 2.83 times (95: 2.45-3.26) and 1.35 times (95: 1.15-1.59) higher than those who did not receive any treatment, respectively. Higher risks on death seemed to be related to the following factors: being male, older age at the time of diagnosis, lower CD(4) at diagnosis, not on ART or MMT among the IDUs with HIV/AIDS in Guizhou province, between 1996-2015.
为了解1996 - 2015年贵州省注射吸毒感染艾滋病毒/艾滋病者的死亡率及影响因素。对1996 - 2015年期间通过国家综合艾滋病毒/艾滋病信息系统报告的注射吸毒感染艾滋病毒/艾滋病者进行回顾性队列研究。采用Cox比例风险回归模型分析艾滋病毒/艾滋病死亡率的影响因素。本研究共纳入3958例注射吸毒感染艾滋病毒/艾滋病者，全因死亡率为44.01（1742/3958），总死亡率为7.80/100人年。诊断至死亡的中位生存时间为8.08年。接受抗逆转录病毒治疗（ART）组的死亡率为3.57/100人年。接受美沙酮维持治疗（MMT）组的死亡率为4.08/100人年。多元回归分析数据表明，性别、民族、艾滋病毒/艾滋病诊断时的年龄、首次检测时的CD4+T淋巴细胞（CD4）计数、ART和MMT等因素与这些人的死亡显著相关。女性死亡风险比男性高0.82倍（95%：0.69 - 0.98）。少数民族受试者的死亡风险比汉族高1.39倍（95%：1.21 - 1.60）。首次诊断艾滋病毒/艾滋病时，50岁以上年龄组的死亡风险比20岁以下年龄组高2.44倍（95%：1.07 - 5.56）。首次CD4≥500/μl组的死亡风险比首次CD4<200/μl组高0.27倍（95%：0.22 - 0.32）。接受ART或MMT治疗的病例死亡风险分别比未接受任何治疗的病例高2.83倍（95%：2.45 - 3.26）和1.35倍（95%：1.15 - 1.59）。1996 - 2015年期间，贵州省注射吸毒感染艾滋病毒/艾滋病者中，较高的死亡风险似乎与以下因素有关：男性、诊断时年龄较大、诊断时CD4较低、未接受ART或MMT治疗。
