Jin Y C, Cai C, Chen F F, Qin Q Q, Tang H L
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. 2022 Jun 10;43(6):860-864. doi: 10.3760/cma.j.cn112338-20211214-00981.
To understand death's mortality and risk factors among HIV-positive injecting drug users (IDU) aged 15 or above in China and provide further reference to future prevention and treatment policies. Retrospective cohort study was conducted to calculate the mortality rate of HIV-positive IDU based on HIV/AIDS Comprehensive Response Information Management System. Cox proportion hazards regression model was performed to assess the risk factors for deaths. The Excel 2019 and SPSS 22.0 software was used for data cleaning and statistical analysis. Between 2001 and 2020, 119 209 HIV-positive IDU were reported with 59 094 deaths. The all-cause mortality rate was 6.96 per 100 person-years (py), and the AIDS-related mortality rate was 1.91 per 100 py, with a decreasing trend over the years. Multivariate Cox regression indicated for all-cause death risks of HIV-positive IDU, compared with those baseline T lymphocyte cells (CD4) counts above 500 cells/μl, the (95%) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 2.85 (2.78-2.93), 2.47 (2.40-2.54), 1.58 (1.53-1.62) and 1.24 (1.21-1.28) respectively. The (95%) of antiretroviral treatment (ART) naïve was 7.13 (6.99-7.27) compared with those under ART. The (95%) of methadone maintenance treatment (MMT) naïve was 1.07 (1.04-1.10) compared to those receiving MMT. As for AIDS-related death risks, compared with baseline T+ lymphocyte cell CD4 counts >500 cells/μl, the (95%) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 3.26 (3.08-3.46), 5.54 (5.24-5.85), 2.35 (2.21-2.50) and 1.41 (1.32-1.50). (95%) of ART naïve was 5.96(5.74-6.18) compared to those under ART. Further efforts should be made timely on diagnosis, treatment, and harm reduction programs such as MMT for improvement compliance to reduce mortality risks of HIV-positive IDU.
为了解中国15岁及以上HIV阳性注射吸毒者（IDU）的死亡率及危险因素，为未来的预防和治疗政策提供进一步参考。采用回顾性队列研究，基于艾滋病综合防治信息管理系统计算HIV阳性IDU的死亡率。采用Cox比例风险回归模型评估死亡危险因素。使用Excel 2019和SPSS 22.0软件进行数据清理和统计分析。2001年至2020年期间，报告了119209例HIV阳性IDU，其中59094例死亡。全因死亡率为每100人年6.96例，艾滋病相关死亡率为每100人年1.91例，且多年来呈下降趋势。多变量Cox回归表明，对于HIV阳性IDU的全因死亡风险，与基线T淋巴细胞（CD4）计数高于500个细胞/μl的人相比，CD4计数未检测、0-199、200-349、350-500个细胞/μl的人（95%）分别为2.85（2.78-2.93）、2.47（2.40-2.54）、1.58（1.53-1.62）和1.24（1.21-1.28）。与接受抗逆转录病毒治疗（ART）的人相比，未接受ART的人（95%）为7.13（6.99-7.27）。与接受美沙酮维持治疗（MMT）的人相比，未接受MMT的人（95%）为1.07（1.04-1.10）。至于艾滋病相关死亡风险，与基线T+淋巴细胞CD4计数>500个细胞/μl的人相比，CD4计数未检测、0-199、200-349、350-500个细胞/μl的人（95%）分别为3.26（3.08-3.46）、5.54（5.24-5.85）、2.35（2.21-2.50）和1.41（1.32-1.50）。与接受ART的人相比，未接受ART的人（95%）为5.96（5.74-6.18）。应及时在诊断、治疗和减少伤害项目（如MMT）方面做出进一步努力，以提高依从性，降低HIV阳性IDU的死亡风险。
