Wang Shi, Tang Houlin, Zhao Decai, Cai Chang, Jin Yichen, Qin QianQian, Chen Fangfang, Fei Liping, Zhao Hehe, Yang Zhongnian, Lyu Fan
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
China CDC Wkly. 2024 Nov 29;6(48):1264-1270. doi: 10.46234/ccdcw2024.253.
A comprehensive analysis of nationwide survival trends for people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS, PLWHA) from the initial reported case to present has not been conducted. This study evaluated the survival outcomes of PLWHA reported in China from 1985 to 2022.
We analyzed data from PLWHA recorded in the National HIV/AIDS Comprehensive Response Information Management System from 1985 to 2022. Survival rates were calculated using Kaplan-Meier curves, and factors associated with survival time were analyzed using Cox proportional hazard models.
Progressive relaxation of antiretroviral therapy initiation criteria led to significant improvements in survival rates across different diagnostic periods in China. The 1-year and 5-year cumulative survival rates increased from 85.2% and 66.1% in the 1985-2003 cohort to 91.1% and 81.4% in the 2016-2022 cohort. Cox proportional hazard analysis revealed elevated mortality risks among males, individuals aged ≥65 years, those with injection drug use or other transmission routes, hospital-tested patients, and those with lower CD4 counts at diagnosis or without treatment.
Antiretroviral therapy has effectively reduced mortality risk among PLWHA in China. Future efforts should focus on expanding HIV testing to reduce the proportion of late diagnoses with lower CD4 counts and providing targeted, differentiated services for older populations to further decrease mortality risk among PLWHA.
尚未对全国范围内从最初报告病例到目前的人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS，艾滋病病毒感染者/艾滋病患者）感染者的生存趋势进行全面分析。本研究评估了1985年至2022年在中国报告的艾滋病病毒感染者/艾滋病患者的生存结局。
我们分析了1985年至2022年国家HIV/AIDS综合防治信息管理系统中记录的艾滋病病毒感染者/艾滋病患者的数据。使用Kaplan-Meier曲线计算生存率，并使用Cox比例风险模型分析与生存时间相关的因素。
抗逆转录病毒治疗起始标准的逐步放宽使中国不同诊断时期的生存率得到显著提高。1年和5年累积生存率从1985 - 2003队列中的85.2%和66.1%提高到2016 - 2022队列中的91.1%和81.4%。Cox比例风险分析显示，男性、年龄≥65岁的个体、有注射吸毒或其他传播途径的人、医院检测出的患者以及诊断时CD4细胞计数较低或未接受治疗的患者死亡风险升高。
抗逆转录病毒治疗有效降低了中国艾滋病病毒感染者/艾滋病患者的死亡风险。未来的工作应侧重于扩大HIV检测以降低CD4细胞计数较低的晚期诊断比例，并为老年人群提供有针对性的差异化服务，以进一步降低艾滋病病毒感染者/艾滋病患者的死亡风险。
