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马来西亚半岛东北部获得性免疫缺陷综合征患者的生存时间及死亡预后因素

Survival Time and Prognostic Factors of Mortality among Patients with Acquired Immunodeficiency Syndrome in North-East Peninsular Malaysia.

作者信息

Ngah Hamiza, Hairon Suhaily Mohd, Yaacob Najib Majdi, Yusoff Haniah

机构信息

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

出版信息

Malays J Med Sci. 2019 Jul;26(4):70-78. doi: 10.21315/mjms2019.26.4.8. Epub 2019 Aug 29.

Abstract

BACKGROUND

Death resulting from the acquired immunodeficiency syndrome (AIDS) is a worldwide concern. This study is aimed at determining the overall median survival time, and the prognostic factors of mortality among AIDS-infected patients in North-East Peninsular Malaysia.

METHODS

In 2018, a retrospective cohort study stretching from January to April was conducted. This study involved a review of data obtained from the National AIDS Registry. A total of 1,073 AIDS cases diagnosed from 1 January 2010 to 31 December 2014 were selected, and follow-up procedures were conducted until 31 March 2015 (a 3-month follow-up). The Kaplan-Meier plot and Cox's proportional hazard regression were used for data analyses.

RESULTS

564 (52.5%) patients died due to AIDS, while the remaining 509 (47.4%) were censored. The overall median survival time was 11 months. The probability of survival in 1-year, 2-year, 3-year, 4-year and 5-year periods were 49.1%, 47.8%, 47.3%, 47.0% and 46.7%, respectively. Multiple Cox regression revealed that the significant prognostic factors were age 30-49 years [adjusted hazard ratio (Adj. HR) 1.57; 95% CI: 1.14, 2.16; = 0.006], male (Adj. HR 1.39; 95% CI: 1.07, 1.79; = 0.012), unemployed (Adj. HR 1.40; 95% CI: 1.12, 1.75; = 0.003) and HIV-TB co-infection (Adj. HR 1.78; 95% CI: 1.37, 2.31; < 0.001).

CONCLUSION

The overall median survival time among AIDS patients in North-East Peninsular Malaysia was revealed to be short, in comparison to the other studies. The chances for survival can be improved with more emphasis on early detection (to ensure early treatment) and social support, particularly for HIV-TB co-infected patients, as well as for younger and unemployed patients.

摘要

背景

获得性免疫缺陷综合征(艾滋病)导致的死亡是一个全球性问题。本研究旨在确定马来西亚半岛东北部艾滋病感染患者的总体中位生存时间以及死亡的预后因素。

方法

2018年,进行了一项从1月至4月的回顾性队列研究。本研究涉及对从国家艾滋病登记处获得的数据进行审查。选取了2010年1月1日至2014年12月31日期间诊断的1073例艾滋病病例,并进行随访程序直至2015年3月31日(3个月的随访)。采用Kaplan-Meier曲线和Cox比例风险回归进行数据分析。

结果

564例(52.5%)患者死于艾滋病,其余509例(47.4%)被截尾。总体中位生存时间为11个月。1年、2年、3年、4年和5年的生存概率分别为49.1%、47.8%、47.3%、47.0%和46.7%。多因素Cox回归显示,显著的预后因素为年龄30 - 49岁[调整后风险比(Adj. HR)1.57;95%置信区间(CI):1.14,2.16;P = 0.006]、男性(Adj. HR 1.39;95% CI:1.07,1.79;P = 0.012)、失业(Adj. HR 1.40;95% CI:1.12,1.75;P = 0.003)和HIV-TB合并感染(Adj. HR 1.78;95% CI:1.37,2.31;P < 0.001)。

结论

与其他研究相比,马来西亚半岛东北部艾滋病患者的总体中位生存时间较短。通过更加强调早期检测(以确保早期治疗)和社会支持,特别是对HIV-TB合并感染患者以及年轻和失业患者,可以提高生存机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c711/6719878/1d8947cee4e9/08mjms26042019_oa5f1.jpg

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