摘要
目的了解福建省2004-2020年成人艾滋病ART患者生存情况及其影响因素。方法采用回顾性分析方法,收集2004-2020年参与艾滋病ART的18244例成人患者基本情况及可能影响患者ART后生存情况的影响因素等信息,计算治疗患者的全死因病死率、生存时间和生存率,运用COX比例风险模型和分类回归树模型分析治疗患者生存情况的影响因素及不同参数变量对病例生存影响的重要性,并应用ROC曲线评价模型预测效果。结果截至2020年底,福建省18244例成人艾滋病ART患者中,累计报告1367例患者死亡,全死因病死率为2.14/100人年,5年生存率为0.91;COX比例风险模型显示,婚姻状况为已婚同居或其他、感染途径为异性性传播和其他、末次VL≥1000copies/mL的治疗患者死亡风险较高,而女性、文化程度较高、最近一次CD4细胞水平较高则死亡风险较低;回归树模型显示末次VL水平是艾滋病ART患者生存情况的首要影响因素,ROC曲线下面积为0.64(95%CI:0.62~0.67)。结论福建省成人艾滋病ART人群中,女性、未婚、同性性行为、文化程度较高者死亡风险较低,提高CD4细胞水平、控制病毒复制可以减少死亡和延长生存时间。
Objective To investigate the survival status and influencing factors of adult AIDS patients receiving antiretroviral therapy in Fujian Province from 2004 to 2020.Methods Retrospective analysis was carried out to collect the basic information of 18244 adult AIDS patients who received antiretroviral treatment from 2004 to 2020 and the factors affecting the survival status of patients after antiretroviral therapy.The overall mortality,survival time,and survival rate were calculated.Cox proportional hazards model and classified regression tree model were used to analyze the influencing factors of survival and the importance of different parameter variables on survival.Receiver operating characteristic curve(ROC)was used to evaluate the predictive effect of the model.Results By the end of 2020,a total of 1367 deaths had been reported in 18244 adult AIDS patients receiving antiretroviral therapy in Fujian Province.The allcause mortality was 2.14/100 person-years,and the 5-year survival rate was 0.91.Cox proportional risk model showed that patients who were married,cohabited,or otherwise,infected through homosexual practice and whose last viral loads were equal or greater than 1000 copies/ml had higher death risks.However,the death rate was lower in females or patients with better education and a higher level of the last CD4.Data from the classification and regression tree model demonstrated that the previous viral load level showed a strong survival status impact.The area under the ROC was 0.64(95%CI:0.62-0.67).Conclusion Adult AIDS patients who were female,unmarried,infected through homosexualparctice and received better education had a lower risk of death in Fujian.Improving CD4 count and controlling virus replication could decrease mortality and increase the survival time among the patients.
作者
邱月锋
吴守丽
夏品苍
王征桦
张春阳
谢美榕
QIU Yuefeng;WU Shouli;XIA Pincang;WANG Zhenghua;ZHANG Chunyang;XIE Meirong(Centers for Disease Control and Prevention of Fujian Province,Fuzhou 350001,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2022年第1期92-96,共5页
Chinese Journal of Aids & STD
基金
福建省卫生健康科研人才培养项目(2019-CX-9)
福建省科技厅引导性项目(2019Y0053)
2019年福建省科技创新平台建设项目计划(2019Y2001)。
关键词
生存情况
艾滋病
抗病毒治疗
survival status
AIDS
antiretroviral therapy
