摘要
目的了解云南省接受艾滋病ART的HIV感染者期望寿命及其变化。方法对在云南接受ART成人患者编制2020年简略现时寿命表计算期望寿命,分析不同特征患者期望寿命的差别,对比全部患者和治疗6个月仍存活患者的期望寿命。分析历年来不同基线CD4细胞水平的20、30、40、50岁ART患者期望寿命的变化趋势。结果136279例ART患者中,男性占63.3%,异性性传播占75.5%,基线WHO临床分期Ⅰ期占51.5%,Ⅱ期至Ⅳ期占比依次递减,2012-2016年和2017-2020年启动治疗患者较多,分别占43.7%和36.3%,基线CD4细胞中位数252(141,370)个/mm^(3),启动治疗时中位年龄为38(31,48)岁。2020年,女性期望寿命高于男性,静脉吸毒者期望寿命最低,异性性传播者期望寿命最高,基线WHO临床分期Ⅰ期和Ⅱ期患者的期望寿命高于Ⅲ期和Ⅳ期患者,基线CD4细胞计数在350个/mm^(3)及以上患者的期望寿命与200~349个/mm^(3)的患者相当,均高于0~199个/mm^(3)的患者。2020年,与全部患者相比,治疗6个月仍存活患者的期望寿命在基线Ⅳ期、基线Ⅲ期、同性性传播、基线CD4细胞0~199个/mm^(3)和异性性传播组分别升高了4.4年、3.2年、2.8年、2.8年和2.0年;2009年至2020年,20、30、40、50岁不同基线CD4细胞患者的期望寿命都有上升趋势。年龄越大,上升趋势越不明显。基线CD4细胞计数越高,期望寿命越高。结论云南省接受ART患者的期望寿命逐渐升高。早发现、早治疗,关注晚治疗患者头6个月效果,关注男性患者可进一步提高云南省ART患者期望寿命。
Objective To learn about the trend of life expectancy among people living with HIV/AIDS(PLWHA)under antiretroviral therapy(ART)in Yunnan,China.Methods Abridged life table to calculate life expectancy for PLWHA with ART in 2020 was formed to analyze the life expectancy based on various characteristics and compared the life expectancy between total cases and the PLWHA at 6-month after the initiation of ART.The trends of life expectancy with baseline CD4 ranges were analyzed at 20-,30-,40-and 50-year-old.Results A total of 136,279 ART cases were included in the analysis.Males and heterosexual sexually transmitted HIV accounted for 63.3%and 75.5%,respectively.The percentage of WHO clinical stageⅠwas 51.5%,with a decreasing rate for stagesⅡtoⅣ.The percentage of ART initiation years of 2012-2016 and 2017-2020 was 43.7%and 36.3%,respectively.The baseline median CD4 count was 252(141-370)cells/mm^(3).The median age of initiating ART was 38(31-48)years.In 2020,the life expectancy in women was higher than that in men.The lowest was in intravenous drug users and the highest was in those with heterosexual transmitted infection.Cases with WHO clinical stageⅠandⅡhad a higher life expectancy than those with stagesⅢandⅣ.The average baseline CD4 was 252(141-370)/mm^(3) and the patients with a baseline CD4 of 350/mm^(3) or above had almost the same life expectancy as those who had a CD4 count of 200-349/mm^(3) and both of them were higher than patients with CD4 of 0~199/mm^(3).In 2020,compared to the total cases,the life expectancies among PLWHA at 6-months after ART initiation had longer of 4.4,3.2,2,8,2.8,and 2,0 years than people with WHO clinical stageⅣ,stageⅢ,homosexual transmission,baseline CD4 range 0-199,and heterosexual transmission.Between2009 to 2020,the life expectancy of patients aged 20,30,40,and 50 with various ranges of baseline CD4 counts had an increasing trend.However,life expectancy was not significantly associated with increased age.Conclusion In Yunnan province,the life expectancy of PLWHA receiving ART was increasing.Early detection,early treatment,and paying attention to the treatment effect of patients with late detection or late treatment in the first six months of treatment might help to increase the life expectancy.More efforts should be made to male patients to further improve the life expectancy of ART patients.
作者
安靓
劳云飞
楼金成
AN Jing;LAO Yunfei;LOU Jincheng(Yunnan Provincial Infectious Disease Hospital/Yunnan AIDS Care Center,Kunming 650301,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2022年第2期127-132,共6页
Chinese Journal of Aids & STD
基金
云南省科技厅昆明医科大学应用基础研究联合专项项目(202001AY070001-105)。
关键词
艾滋病
抗病毒治疗
期望寿命
AIDS
Antiretroviral therapy
Life expectancy
