Zhou Yihong, Yang Zhongping, Liu Min, Lu Yanqiu, Qin Yuanyuan, He Xiaoqing, Zeng Yanming, Harypursat Vijay, Chen Yaokai
Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China.
National Key Laboratory for Infectious Diseases Prevention and Treatment With Traditional Chinese Medicine, Chongqing Public Health Medical Center, Chongqing, China.
Front Med (Lausanne). 2021 Feb 17;7:586390. doi: 10.3389/fmed.2020.586390. eCollection 2020.
People living with HIV (PLWH) are aging worldwide, and different management strategies may be required for older and younger PLWH. However, demographic characteristics, illness distribution, mortality, and independent risk factors in the PLWH population in China are not yet fully understood, especially in patients aged 50 years or older. We conducted a retrospective analysis of 4445 HIV-positive Chinese inpatients in Chongqing, China. The mortality rate in patients 50 years or older (the older group) was significantly higher than that in those under 50 years (the younger group) ( < 0.001). In the younger group, independent risk factors for death included: nadir CD4+ T-cell counts <200 cells/μL, not owning medical healthcare insurance, not being on cART, injection drug use, and having one of the following comorbidities: Pneumocystis pneumonia, cryptococcal meningitis, AIDS malignancy, non-AIDS malignancy, and kidney disease. In the older group, independent predictors of death included: being urban residents, nadir CD4+ T-cell counts <200 cells/μL, not being on cART, and having comorbidities such as Pneumocystis pneumonia, hepatitis C, talaromycosis, non-AIDS malignancy, and kidney disease. Demographic characteristics, illness distribution, mortality, and independent risk factors for death in HIV-positive patients differ between the older group and the younger group, indicating that a changing suite of medical and allied support services may be required the for management of older PLWH.
全球范围内，感染艾滋病毒的人（PLWH）正在老龄化，老年和年轻的PLWH可能需要不同的管理策略。然而，中国PLWH人群的人口统计学特征、疾病分布、死亡率和独立危险因素尚未完全明确，尤其是50岁及以上的患者。我们对中国重庆的4445名艾滋病毒阳性住院患者进行了回顾性分析。50岁及以上患者（老年组）的死亡率显著高于50岁以下患者（年轻组）（<0.001）。在年轻组中，死亡的独立危险因素包括：最低点CD4 + T细胞计数<200个细胞/μL、没有医疗保险、未接受抗逆转录病毒治疗（cART）、注射吸毒，以及患有以下合并症之一：肺孢子菌肺炎、隐球菌性脑膜炎、艾滋病相关恶性肿瘤、非艾滋病相关恶性肿瘤和肾病。在老年组中，死亡的独立预测因素包括：城市居民、最低点CD4 + T细胞计数<200个细胞/μL、未接受cART，以及患有合并症如肺孢子菌肺炎、丙型肝炎、塔拉霉病、非艾滋病相关恶性肿瘤和肾病。老年组和年轻组艾滋病毒阳性患者的人口统计学特征、疾病分布、死亡率和死亡的独立危险因素有所不同，这表明可能需要一套不断变化的医疗及相关支持服务来管理老年PLWH。
