[2010 - 2019年德宏傣族景颇族自治州HIV阳性个体接受抗逆转录病毒治疗后艾滋病相关及非艾滋病相关死亡的发生率及影响因素]
[Incidence and influencing factors of AIDS-related and non-AIDS-related deaths after receiving antiretroviral therapy among HIV-positive individuals in Dehong Dai and Jingpo Autonomous Prefecture, 2010-2019].
作者信息
Yao S T, He C Y, Cao D D, Zhang Y D, Shi Y, Li P Y, Feng Y L, Wei H, Xiao G F, Sun J T, Ye R H, Yang Y C, Wang J B, He N, Ding Y Y, Duan S
机构信息
Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention, Mangshi 678400, China.
Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China.
出版信息
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Apr 10;42(4):632-637. doi: 10.3760/cma.j.cn112338-20200903-01121.
To explore the changing trends and influencing factors of AIDS-related and non-AIDS-related deaths after receiving antiretroviral therapy (ART) among HIV-positive individuals in Dehong Dai Jingpo autonomous prefecture (Dehong) from 2010 to 2019. Based on the Chinese National treatment database, HIV patients who initiated ART from 2010 to 2019 were included in the analysis. The cumulative incidence function was used to estimate the cumulative incidence of AIDS-related death and non-AIDS-related death, respectively. The Fine-Grey model was used to compare the differences between AIDS-related and non-AIDS-related deaths and analyze its influencing factors. A total of 7 068 HIV-positive individuals were included, of which 388 were AIDS-related deaths and 570 were non-AIDS-related deaths. The cumulative mortality rate at years 1, 2, 3, 4, 5, 7 and 9 after receiving ART were 2.27%, 3.46%, 4.47%, 5.03%, 5.84%, 6.61%, 7.40% for AIDS-related deaths, and 1.63%, 3.11%, 4.68%, 6.02%, 7.42%, 10.49%, 12.75% for non-AIDS-related deaths, respectively. In the Fine-Grey model, older age at ART initiation, male, unmarried, injection drug use as the transmission route, lower baseline BMI, lower baseline CD4 T cell counts, baseline FIB-4 score >3.25, and baseline anemia were risk factors for AIDS-related death. In contrast, age at ART initiation ≥45 years, male, Dai, and Jingpo minority ethnicities, unmarried, injection drug use as the transmission route, lower baseline BMI, baseline FIB-4 score >3.25, baseline eGFR <60 ml·min·1.73 m, and baseline anemia were risk factors for non-AIDS-related deaths. The cumulative mortality rate was low among HIV-positive individuals after receiving ART in Dehong during 2010-2019. The mortality of non-AIDS-related deaths was higher than that of AIDS-related deaths. There were also differences in the factors influencing AIDS-related and non-AIDS-related deaths and interventions should be intensified to target the influencing factors for non-AIDS-related deaths.
为探讨2010年至2019年期间德宏傣族景颇族自治州（德宏）HIV阳性个体接受抗逆转录病毒治疗（ART）后艾滋病相关死亡和非艾滋病相关死亡的变化趋势及影响因素。基于中国国家治疗数据库，纳入2010年至2019年开始接受ART的HIV患者进行分析。采用累积发病率函数分别估计艾滋病相关死亡和非艾滋病相关死亡的累积发病率。使用Fine-Grey模型比较艾滋病相关死亡和非艾滋病相关死亡之间的差异并分析其影响因素。共纳入7068例HIV阳性个体，其中艾滋病相关死亡388例，非艾滋病相关死亡570例。接受ART后第1、2、3、4、5、7和9年的艾滋病相关死亡累积死亡率分别为2.27%、3.46%、4.47%、5.03%、5.84%、6.61%、7.40%，非艾滋病相关死亡累积死亡率分别为1.63%、3.11%、4.68%、6.02%、7.42%、10.49%、12.75%。在Fine-Grey模型中，开始ART时年龄较大、男性、未婚、注射吸毒为传播途径、基线BMI较低、基线CD4 T细胞计数较低、基线FIB-4评分>3.25以及基线贫血是艾滋病相关死亡的危险因素。相比之下，开始ART时年龄≥45岁、男性、傣族和景颇族少数民族、未婚、注射吸毒为传播途径、基线BMI较低、基线FIB-4评分>3.25、基线eGFR<60 ml·min·1.73 m以及基线贫血是非艾滋病相关死亡的危险因素。2010 - 2019年期间德宏HIV阳性个体接受ART后的累积死亡率较低。非艾滋病相关死亡的死亡率高于艾滋病相关死亡。艾滋病相关死亡和非艾滋病相关死亡的影响因素也存在差异，应加强针对非艾滋病相关死亡影响因素的干预措施。
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