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[2002年至2020年河南省15岁及以上长期接受抗逆转录病毒治疗的艾滋病病毒/艾滋病患者生存分析]

[Survival analysis of long-term HIV/AIDS cases aged 15 years and over under antiretroviral treatment in Henan Province from 2002 to 2020].

作者信息

Yang W J, Li J, Ma Y M, Liu Y, Xuan S L, Li N

机构信息

Institute for Chronic and Noncommunicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2022 Jul 6;56(7):919-925. doi: 10.3760/cma.j.cn112150-20220112-00045.

Abstract

To analyze the survival and influencing factors of HIV infections and AIDS cases (HIV/AIDS) aged 15 years and over who had received antiretroviral treatment (ART) for more than 10 years in Henan Province. In this retrospective cohort study, data of HIV infections and AIDS cases in Henan province were collected from the AIDS Prevention and Control System between January 1, 2002 and December 31, 2020. This study included 20 256 participants alive after 10-year ART with complete baseline and follow-up information, such as demographic characteristics, CD4T lymphocyte count and viral load. Cox proportional risk regression model was used to analyze influencing factors of HIV/AIDS survival. A total of 20 256 participants were followed up for 82 738.2 person-years, with an average follow-up of 4.1 person-years, of which most cases were blood transmission (85.5%) and married (71.2%). The male to female ratio was 1∶1.06 and the age at 10 years of ART was (51.2±8.7) years old. About 88.5% of HIV/AIDS patients received ART in village/township treatment institutions. Overall, there were 2 030 deaths during this period, among which 1 897 were due to AIDS-related diseases (93.5%) and the case fatality rate was 9.4% (1 897/20 256). Cox proportional risk regression model showed that participants aged 40-54, 55-69, and ≥70 years had a higher risk of death compared to those aged 25-39, with adjusted HRs (95%) of 1.57 (1.19-2.08), 3.78 (2.86-4.99), and 6.17 (4.33-8.79), respectively. Participants with the initial CD4T lymphocyte count about 200-349/μl and<200/μl had a higher risk of death compared to those with initial CD4T lymphocyte count ≥350/μl, with adjusted HRs (95%) of 1.81 (1.61-2.04) and 3.64 (3.20-4.15), respectively. Participants with the initial viral load outcome ≥1 000 copies/ml had a higher risk of death compared to those with the initial viral load outcome<1 000 copies/ml, with adjusted HRs (95%) of 1.73 (1.52-1.97). Participants receiving the second-line ART had a lower risk of death compared to those receiving the first-line ART, with adjusted HRs (95%) of 0.12 (0.11-0.14). From 2002 to 2020, the survival rate of HIV/AIDS treated with ART for more than 10 years is high in Henan Province. Age, CD4T lymphocyte count and viral load are influencing factors of HIV/AIDS survival.

摘要

分析河南省15岁及以上接受抗逆转录病毒治疗(ART)超过10年的HIV感染者和艾滋病患者(HIV/AIDS)的生存情况及影响因素。在这项回顾性队列研究中,收集了2002年1月1日至2020年12月31日期间河南省艾滋病防治系统中HIV感染者和艾滋病患者的数据。本研究纳入了20256名接受10年ART治疗后存活且具有完整基线和随访信息的参与者,如人口统计学特征、CD4T淋巴细胞计数和病毒载量。采用Cox比例风险回归模型分析HIV/AIDS生存的影响因素。共对20256名参与者进行了82738.2人年的随访,平均随访4.1人年,其中大多数病例为血液传播(85.5%)且已婚(71.2%)。男女比例为1∶1.06,ART治疗10年时的年龄为(51.2±8.7)岁。约88.5%的HIV/AIDS患者在村/乡镇治疗机构接受ART治疗。在此期间,共有2030例死亡,其中1897例死于艾滋病相关疾病(93.5%),病死率为9.4%(1897/20256)。Cox比例风险回归模型显示,与25 - 39岁的参与者相比,40 - 54岁、55 - 69岁和≥70岁的参与者死亡风险更高,调整后的HR(95%)分别为1.57(1.19 - 2.08)、3.78(2.86 - 4.99)和6.17(4.33 - 8.79)。初始CD4T淋巴细胞计数约为200 - 349/μl和<200/μl的参与者与初始CD4T淋巴细胞计数≥350/μl的参与者相比,死亡风险更高,调整后的HR(95%)分别为1.81(1.61 - 2.04)和3.64(3.20 - 4.15)。初始病毒载量结果≥1000拷贝/ml的参与者与初始病毒载量结果<1000拷贝/ml的参与者相比,死亡风险更高,调整后的HR(95%)为1.73(1.52 - 1.97)。接受二线ART治疗的参与者与接受一线ART治疗的参与者相比,死亡风险更低,调整后的HR(95%)为0.12(0.11 - 0.14)。2002年至2020年,河南省接受ART治疗超过10年的HIV/AIDS患者生存率较高。年龄、CD4T淋巴细胞计数和病毒载量是HIV/AIDS生存的影响因素。

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