Cai C, Tang H L, Li D M, Lyu P
Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Jan 10;42(1):121-125. doi: 10.3760/cma.j.cn112338-20200918-01169.
To understand the basic characteristics of death cases, analyze the death trends in AIDS patients and the risk factors in China and provide evidence for the development of AIDS prevention and control strategy. The data were collected from the national basic information system of HIV/AIDS. The information of the cases in AIDS phase were used. The death number and mortality trends in AIDS cases were described, and Cox Proportion Hazards Regression Model was constructed to assess hazard ratios () for independent variables. By the end of 2019, a total of 582 472 AIDS cases, including 168 391 deaths, had been reported in China. Among the death cases, males accounted for 76.8% (129 343/168 391), heterosexual contact was the main transmission route, accounting for 60.9% (102 516/168 391). The proportion of the death cases who had ever received ART was 54.0% (90 888/168 391). The inter-quartile (, ) of first CDT cells counts (CD) was 34 cells/μl, 240 cells/μl. Up to 43.5% (73 191/168 391) of the deaths occurred within one year after diagnosis. From 2007 to 2019, the annual death number increased from 5 485 to 18 737, the mortality rates decreased form 10.9%% to 4.3%. The average time interval from diagnosis to death ranged from 1.4 year to 4.0 years, showing increase trend by year. The results of Cox regression analysis showed that older age (50- years old: =1.50; ≥65 years old: =2.00), being male (=1.44)、being in minority ethnic group (=1.10), having lower first CD levels (0- cells/μl, =2.73;200- cells/μl, =1.33; 350- cells/μl,=1.13), heterosexual transmission route (=1.64) and injecting drug use (=1.79) were the risk factors related to deaths in AIDS patients. The higher educational levels (junior middle school: =0.86, senior high school and above: =0.59) and receiving antiviral treatrment (=0.09) were protective factors. The number of death cases increased, meanwhile the mortality rates decrease year by year in AIDS patients in China during 2007-2019. It is necessary to strengthen the early detection and treatment of AIDS to reduce the mortality.
为了解死亡病例的基本特征，分析我国艾滋病患者的死亡趋势及危险因素，为制定艾滋病防控策略提供依据。数据来源于全国艾滋病病毒/艾滋病基本信息系统，采用艾滋病期病例信息，描述艾滋病病例的死亡人数及死亡率变化趋势，构建Cox比例风险回归模型评估各因素的风险比。截至2019年底，我国共报告艾滋病病例582472例，其中死亡168391例。死亡病例中男性占76.8%（129343/168391），异性传播为主要传播途径，占60.9%（102516/168391）。接受过抗病毒治疗的死亡病例比例为54.0%（90888/168391）。首次CD4+T淋巴细胞计数（CD4）的四分位数间距为34个/μl、240个/μl。43.5%（73191/168391）的死亡发生在确诊后1年内。2007—2019年，艾滋病死亡人数由5485例增至18737例，死亡率由10.9%降至4.3%。确诊至死亡的平均时间间隔为1.4～4.0年，呈逐年上升趋势。Cox回归分析结果显示，年龄较大（50～岁：HR = 1.50；≥65岁：HR = 2.00）、男性（HR = 1.44）、少数民族（HR = 1.10）、首次CD4水平较低（0～个/μl，HR = 2.73；200～个/μl，HR = 1.33；350～个/μl，HR = 1.13）、异性传播途径（HR = 1.64）及注射吸毒（HR = 1.79）是艾滋病患者死亡的危险因素；文化程度较高（初中：HR = 0.86，高中及以上：HR = 0.59）及接受抗病毒治疗（HR = 0.09）是保护因素。2007—2019年我国艾滋病患者死亡人数增加，但死亡率逐年下降，应加强艾滋病的早发现早治疗以降低死亡率。
