Abstract：Objective To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. Methods The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model. Results Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. Conclusions The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.
周涛, 李月飞, 白雪, 胡晓远, 马媛媛, 倪明健. 2005—2019年伊犁州抗病毒治疗吸毒人群HIV/AIDS病例生存分析[J]. 预防医学, 2021, 33(1): 25-30.
ZHOU Tao, LI Yuefei, BAI Xue, HU Xiaoyuan, MA Yuanyuan, NI Mingjian. Survival analysis of HIV/AIDS patients with antiretroviral therapy among drug users in Yili Prefecture from 2005 to 2019. Preventive Medicine, 2021, 33(1): 25-30.
[1] ALVAREZ P A,VALERIO J E,SWEDBERG H N,et al.Highly active antiretroviral therapy and gamma knife radiosurgery for the treatment of AIDS-related primary central nervous system lymphoma[J].World Neurosurg,2019,124(16):310-312. [2] ORTBLAD K F,BAETEN J M,CHERUTICH P,et al.The arc of HIV epidemics in sub-Saharan Africa:new challenges with concentrating epidemics in the era of 90-90-90[J].Curr Opin HIV AIDS,2019,14(5):354-365. [3] 杨爱学,陈涛,刘伟.新疆伊犁州直1996—2015年艾滋病病例死亡情况分析[J].中国艾滋病性病,2016,22(10):788-790. [4] 倪明健,陈学玲,胡晓远,等.新疆维吾尔自治区艾滋病抗病毒治疗者死亡率及其影响因素分析[J].中华预防医学杂志,2014,48(11):953-958. [5] 中国疾病预防控制中心性病艾滋病预防控制中心.国家免费艾滋病抗病毒药物治疗手册[M].4版.北京:人民卫生出版社,2016. [6] 豆智慧,张福杰,赵燕,等.2002—2014年中国免费艾滋病抗病毒治疗进展[J].中华流行病学杂志,2015,36(12):1345-1350. [7] 刘芳,施雅莹,吴学庆,等.经性传播艾滋病患者抗病毒治疗的生存分析[J].中国社会医学杂志,2015,32(6):480-483. [8] DAMTEW B,MENGISTIE B,ALEMAYEHU T.Survival and determinants of mortality in adult HIV/AIDS patients initiating antiretroviral therapy in Somali Region,Eastern Ethiopia[J].Pan Afr Med J,2015,22:138-143. [9] NAIDOO K,YENDE Z N,AUGUSTINE S.A retrospective cohort study of body mass index and survival in HIV infected patients with and without TB co-infection[J].Infect Dis Poverty,2018,7(1):35-46. [10] SHOKO C,CHIKOBYU D.A superiority of viral load over CD4 cell count when predicting mortality in HIV patients on therapy[J].BMC Infect Dis,2019,19(1):169. [11] BAJPAI R,CHATURVEDI H,JAYASEELAN L,et al.Effects of antiretroviral therapy on the survival of human immunodeficiency virus-positive adult patients in Andhra Pradesh,India:a retrospective cohort study,2007-2013[J].J Prev Med Public Health,2016,49(6):394-405. [12] 王斌,龚德光,朱洁群.鄞州区艾滋病抗病毒治疗患者生存率及影响因素分析[J].预防医学,2020,32(4):346-350. [13] LODI S,GUNTHARD,HULDRYCH F,et al.Effect of immediate initiation of antiretroviral treatment on the risk of acquired HIV drug resistance[J].AIDS,2018,32(3):327-335. [14] 陈亮,连巧龄,刘美增.福建省1987—2018年HIV/AIDS病例生存情况及其影响因素分析[J].中国公共卫生,2019,35(12):1623-1627. [15] SHARMA S,SCHLUSSER K E,TORRE P,et al.The benefit of immediate compared with deferred antiretroviral therapy on CD4 cell count recovery in early HIV infection[J].AIDS,2019,33(8):1335-1344. [16] ADEOTI A O,DADA M,ELEBIYO T,et al.Survey of antiretroviral therapy adherence and predictors of poor adherence among HIV patients in a tertiary institution in Nigeria[J].Pan Afr Med J,2019,33:277-283. [17] 陈军,曹晓斌,张波,等.云南省两地抗病毒治疗门诊注射吸毒HIV感染者入组美沙酮维持治疗的影响因素分析[J].中华流行病学杂志,2016,37(1):68-71. [18] 周莹,卢静,张之,等.江苏省艾滋病一线药物抗病毒治疗失败病人的耐药特征及影响因素分析[J].中华疾病控制杂志,2017,21(12):1191-1194. [19] 朱晓艳,王国永,孙晓光,等.山东省抗病毒治疗的HIV/AIDS病人的耐药调查结果分析[J].中国艾滋病性病,2017,23(2):107-111. [20] EYASSU M A,MOTHIBA T M,MBAMBO NP.Adherence to antiretroviral therapy among HIV and AIDS patients at the Kwa-Thema clinic in Gauteng Province,South Africa[J].Afr J Prim Health Care Fam Med,2016,8(2):e1-e7. [21] FONSAH J Y,NJAMNSHI A K,KOUANFACK C,et al.Adherence to antiretroviral therapy(ART)in Yaoundé-Cameroon:association with opportunistic infections,depression,ART regimen and side effects[J].PLoS One,2017,12(1):e17-e23.
