李笑琴, 何佳谕, 汪剡灵, 许圆圆, 沈伟伟, 丁盈盈, 何纳, 陈潇潇. 20062019年台州市抗病毒治疗的HIV感染者生存状况分析[J]. 上海预防医学, 2021, 33(9): 779-784. DOI: 10.19428/j.cnki.sjpm.2021.20396
引用本文: 李笑琴, 何佳谕, 汪剡灵, 许圆圆, 沈伟伟, 丁盈盈, 何纳, 陈潇潇. 20062019年台州市抗病毒治疗的HIV感染者生存状况分析[J]. 上海预防医学, 2021, 33(9): 779-784. DOI: 10.19428/j.cnki.sjpm.2021.20396
LI Xiao-qin, HE Jia-yu, WANG Shan-ling, XU Yuan-yuan, SHEN Wei-wei, DING Ying-ying, HE Na, CHEN Xiao-xiao. Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City[J]. Shanghai Journal of Preventive Medicine, 2021, 33(9): 779-784. DOI: 10.19428/j.cnki.sjpm.2021.20396
Citation: LI Xiao-qin, HE Jia-yu, WANG Shan-ling, XU Yuan-yuan, SHEN Wei-wei, DING Ying-ying, HE Na, CHEN Xiao-xiao. Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City[J]. Shanghai Journal of Preventive Medicine, 2021, 33(9): 779-784. DOI: 10.19428/j.cnki.sjpm.2021.20396

20062019年台州市抗病毒治疗的HIV感染者生存状况分析

Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City

  • 摘要:
    目的分析2006—2019年浙江省台州市抗病毒治疗的HIV感染者生存状况及影响因素。
    方法对台州市2006—2019年首次接受抗病毒治疗的HIV感染者进行生存分析,采用Kaplan-Meier (K-M)法计算累积生存率和抗病毒治疗累积成功率,采用单因素和多因素Cox比例风险模型分析抗病毒治疗后HIV感染者生存状况及影响因素。
    结果共纳入2 904例研究对象,K-M法估算抗病毒治疗后1、3、5、8年的累积生存率分别为96.9%、94.9%、93.1%和92.1%,抗病毒治疗累积成功率分别为91.3%、85.3%、81.8%和73.8%。多因素Cox回归分析结果显示,与18~30岁年龄组、基线CD4+T淋巴细胞计数>350个/μL、基线无贫血、抗病毒治疗有效、基线无症状体征、传播途径为同性性传播相比,年龄51~60岁(HR=4.94,95%CI:1.66~14.69)、年龄>60岁(HR=9.14,95%CI:3.14~26.63)、基线贫血(HR=2.24,95%CI:1.55~3.23)、基线CD4+T淋巴细胞计数<200个/μL(HR=4.35,95%CI:2.14~8.86)、抗病毒治疗免疫学失败(HR=3.90,95%CI:2.73~5.58)、异性性传播(HR=1.92,95%CI:1.15~3.20)、基线出现症状体征(HR=1.68,95%CI:1.16~2.41)是HIV感染者死亡的独立危险因素。
    结论台州市抗病毒治疗效果较好,各年累积生存率、抗病毒治疗累积成功率较高。需要重点关注年龄大、有贫血的HIV感染者,加强对抗病毒治疗初期效果的监测,并做好“发现即治”工作,从而进一步降低HIV相关病死率。

     

    Abstract:
    ObjectiveTo examine the survival status and explore factors related to death among human immunodeficiency virus (HIV) infected patients receiving antiretroviral therapy (ART) in Taizhou City during 2006‒2019.
    MethodsA retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier (K-M) method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART.
    ResultsA total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1, 3, 5, and 8 years of ART were 96.9%, 94.9%, 93.1% and 92.1%, respectively, and the cumulative treatment response rate were 91.3%, 85.3%, 81.8% and 73.8%, respectively. Compared with aged 18-30 years old, baseline CD4+T cell >350 count/μL, normal hemoglobin level, effective ART, no clinical symptom at baseline, and homosexual transmission, we found that aged 51-60 years old(HR=4.94,95%CI:1.66-14.69), aged over 60 years old(HR=9.14,95%CI:3.14-26.63), anemia at baseline(HR=2.24,95%CI:1.55-3.23), baseline CD4+T cell <200 count/μL(HR=4.35,95%CI:2.14-8.86), ART failure (HR=3.90,95%CI:2.73-5.58), heterosexual transmission(HR=1.92,95%CI:1.15-3.20), and signs of symptom at baseline(HR=1.68,95%CI:1.16-2.41) were risk factors of HIV-related death.
    ConclusionThe effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.

     

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