常德市性传播艾滋病病毒感染者/艾滋病患者生存状况及影响因素分析

目的 分析常德市经性传播艾滋病病毒感染者(HIV)/艾滋病患者(AIDS)生存状况及影响因素。方法 利用中国疾病预防控制信息系统艾滋病综合防治信息系统,收集2000年1月1日-2016年12月31日经性传播的2 300例HIV/AIDS患者的发病、死亡等信息及影响因素,采用回顾性队列研究分析他们的生存时间及其影响因素。结果 2 300例研究对象平均生存时间为(129.97±3.319)个月,1、5、10、16年累积生存率分别为75.4%、60.0%、48.1%、48.1%。单因素分析显示,患者确诊时的年龄、婚姻状况、文化程度、感染途径和接受艾滋病抗病毒治疗情况是性传播HIV/AIDS生存时间的影响因素(均P＜0.05)。多因素分析显示,确诊HIV抗体阳性时的年龄＞49岁死亡风险高于年龄17～24岁组(HR=2.774,95%CI:1.768～4.353, P=0.000);异性传播病例的死亡风险大于同性传播病例(HR=3.065,95%CI:1.972～4.763, P=0.000);未接受艾滋病抗病毒治疗组的死亡风险高于治疗组(HR=7.414,95%CI:6.193～8.876, P=0.000)。 结论 常德市经性传播HIV/AIDS患者的生存状况一般。年龄、传播途径、治疗接受艾滋病抗病毒治疗是影响生存时间的重要因素。＞49岁和异性传播HIV/AIDS患者死亡风险更高,接受抗病毒治疗可减少AIDS的死亡并延长生存时间。

Survival status and its influencing factors among HIV-infected andAIDS patients by sexual transmission in Changde City

Objective To analyze the survival time and its affecting factors among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients infected through sexual transmission in Changde City. Methods Data regarding the incidence, death and other information and the related factors of 2,300 HIV-infected and AIDS patients infected through sexual transmission from January 1, 2000 to December 31, 2016 were derived from HIV/AIDS Comprehensive Response Information Management System, China Disease Prevention and Control Information System. A retrospective cohort study was conducted to analyze their average survival time and the affecting factors. Results The mean survival time of 2,300 HIV/AIDS patients was (129.97±3.319) months, and the 1-, 5-, 10- and 16-year accumulative survival rates were 75.4%, 60.0%, 48.1% and 48.1% respectively. Univariate analysis showed the age at diagnosis, marital status, educational background, transmission routes and status of receiving highly-active anti-retroviral therapy were the factors affecting survival time of sexually transmitted HIV/AIDS (all P<0.05). Multivariate Cox regression analysis showed that the mortality risk was higher in HIV-infected patients with the age at initial diagnosis more than 49 years old than in those with the age at initial diagnosis between 17 and 24 years old (HR=2.774, 95%CI=1.768-4.353, P=0.000), higher in the patients with heterosexual transmission of HIV than in those with heterosexual transmission of HIV (HR=3.065, 95%CI=1.972-4.763, P=0.000) as well as higher in the patients without receiving highly-active anti-retroviral therapy than those with the therapy(HR=7.414,95%CI=6.193-8.876, P=0.000). Conclusions The survival time of HIV-infected and AIDS patients by sexual transmission in Changde City is median. Age, route of transmission and receiving highly-active anti-retroviral therapy are the important factors affecting the survival time of sexually transmitted HIV/AIDS patients. HIV-infected patients with the age at initial diagnosis > 49 years old and HIV/AIDS patients with heterosexual transmission of HIV have a higher mortality risk, and receiving highly-active anti-retroviral therapy can reduce the death of AIDS and prolong their lives.