陈坚 1梁旭 1农慧桃 1覃彩艳 1谭兰芬 1柳智豪1
作者信息
- 1. 533000广西百色市疾病预防控制中心艾滋病科
- 折叠
摘要
Abstract
Objective To investigate the survival time of HIV/AIDS patients according with treatment standard but not receiving antiretroviral treatment and influencing factors.Methods In this retrospective cohort study, we enrolled 393 HIV/AIDS patients according with treatment standard but not receiving antiretroviral treatment in Baise City from 2005 to 2013.SPSS 21.0 statistical software was used; survival rate was estimated by life table; survival curve was made using Kaplan -Meier method; analysis of influencing factors for survival was conducted using Cox proportional hazard regression.Results The male-female ratio was 2.60∶1, and the average age was (45.8 ±16.6).Patients were mainly married or cohabited with others;they were mainly of Zhuang ethnic minority group; patients with educational level of junior high school took up the highest proportion; most patients were at WHO clinical stageⅠ; and they were mainly infected by sexual activity with opposite sex.The average of CD4+T lymphocyte count was (185 ±112) /mm3; the case fatality rate due to AIDS was 21.04/100 people-years;the median survival time was 78 months 〔95%CI (38.15, 117.85)〕, and the accumulate survival rates of 12, 24, 36, 48 and 60 month were 73.00%, 65.04%, 60.73%, 55.50% and 49.16%. The stratification analysis showed the following results: the fatality rates of patients <55 years old and patients ≥55 years old were 17.60/100 people-years and 32.29/100 people-years; median survival time was 78 months 〔95%CI (33.91, 122.09)〕 and 32 months 〔95%CI (16.95, 47.05)〕respectively, with significant difference (χ2 =4.830, P=0.028); the fatality rates of patients with CD4+T lymphocyte count≤100/mm3 ( group A) , 101-200/mm3 ( group B) and 201-350/mm3 ( group C) were 92.62/100 people-years, 30.64/100 people-years and 5.98/100 people-years, and the median survival time was 4 months 〔95%CI (1.31, 6.69)〕, 24 months 〔95%CI (4.53, 43.49 )〕 and 83 months respectively, with significant differences in survival rate among the three groups (χ2 =141.903, P <0.001 ) . Multivariate Cox proportional hazard regression analysis showed that age, CD4+T lymphocyte count and WHO clinical stages had statistically significant correlation with survival time (P<0.05).Conclusion HIV/AIDS patients according with treatment standard but not receiving antiretroviral treatment have poor prognosis and have high case fatality rate and mortality rate, and patients with higher age and lower CD4+T lymphocyte count and patients with severer opportunistic infectious diseases and tumors have shorter survival time.Therefore, the early detection of AIDS patients, the improvement of follow -up monitoring, timely treatment of opportunistic infectious diseases and early start of antiretroviral treatment are of significant significance in prolonging the survival time of HIV/AIDS patients.关键词
获得性免疫缺陷综合征/未抗病毒治疗/生存分析Key words
Acquired immunodeficiency syndrome/Non-antiretroviral treatment/Survival analysis分类
医药卫生
