Cosentino Federica, Marino Andrea, Anile Laura, Moscatt Vittoria, Gussio Maria, Boscia Vincenzo, Bruno Roberto, Nunnari Giuseppe, Pulvirenti Alfredo, Privitera Grete Francesca, Cacopardo Bruno Santi, Ceccarelli Manuela, Celesia Benedetto Maurizio
Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy.
Unit of Infectious Diseases, "Garibaldi" Hospital, 95122 Catania, Italy.
Infect Dis Rep. 2023 Jan 20;15(1):70-83. doi: 10.3390/idr15010008.
Although the mortality rate among individuals diagnosed during the pre-Highly Active Antiretroviral Treatment era has been substantial, a considerable number of them survived. Our study aimed to evaluate the prevalence of HIV long-term survivors in a cohort of People Living with HIV diagnosed between 1985 and 1994 and to speculate about potential predictive factors associated to long survival. This is a retrospective single-center study. Subjects surviving more than 300 months (25 years) from HIV diagnosis were defined as Long Term Survivors. Overall, 210 subjects were enrolled. More than 75.24% of the included people living with HIV were males, with a median age of 28 years (IQR 25-34). The prevalent risk factors for HIV infection were injection drug use (47.62%), followed by unprotected sex among heterosexual individuals (23.81%). Ninety-three individuals (44.29%) could be defined as LTS with a median (IQR) survival of 333 (312-377) months. A hazard ratio of 12.45 (95% CI 7.91-19.59) was found between individuals who were exposed to Highly Active AntiRetroviral Treatment (HAART) and individuals who were not, with the latter being at greater risk of death. The availability and accessibility of effective antiretroviral therapy for people living with HIV remain the cornerstone of survival.
尽管在高效抗逆转录病毒治疗时代之前被诊断出的个体死亡率很高,但其中相当一部分人存活了下来。我们的研究旨在评估1985年至1994年间被诊断出感染艾滋病毒的人群中艾滋病毒长期存活者的患病率,并推测与长期存活相关的潜在预测因素。这是一项回顾性单中心研究。从艾滋病毒诊断起存活超过300个月(25年)的受试者被定义为长期存活者。总体而言,共纳入了210名受试者。纳入的艾滋病毒感染者中超过75.24%为男性,中位年龄为28岁(四分位间距25 - 34岁)。艾滋病毒感染的常见危险因素是注射吸毒(47.62%),其次是异性恋者中的无保护性行为(23.81%)。93名个体(44.29%)可被定义为长期存活者,中位(四分位间距)生存期为333(312 - 377)个月。接受高效抗逆转录病毒治疗(HAART)的个体与未接受治疗的个体之间的风险比为12.45(95%置信区间7.91 - 19.59),后者死亡风险更高。为艾滋病毒感染者提供有效抗逆转录病毒疗法的可及性仍然是生存的基石。