摘要目的 分析1991-2017年四川省HIV/AIDS生存时间及其影响因素.方法 运用回顾性队列研究方法,对全国艾滋病综合防治数据信息系统中1991-2017年四川省新报告的143 988例HIV/AIDS的资料,采用寿命表法计算生存概率,用Cox比例风险模型分析生存时间的影响因素.结果 143 988例HIV/AIDS中,30420例死于艾滋病及相关疾病(21.1％),平均生存时间为11.51年(95％CI:11.39 ～ 11.64);多因素Cox比例风险模型分析结果显示,HIV/AIDS生存的相关影响因素包括性别(男比女:HR=1.35,95％CI:1.32～ 1.40)、文化程度(小学及以下比初中及以上:HR=1.15,95％CI:1.12～ 1.18)、民族(汉族比其他:HR=1.46,95％CI:1.41～1.52)、职业(农民比其他:HR=1.26,95％CI:1.22～ 1.29)、诊断时年龄(≥55岁比15～24岁:HR=3.18,95％CI:3.02 ～ 3.36)、诊断时疾病状态(艾滋病比HIV感染:HR=1.44,95％CI:1.39～ 1.48)、抗病毒治疗(ART)(接受ART者比未接受ART者:HR=0.20,95％CI:0.19 ～ 0.20)、首次CD4+T淋巴细胞计数(CD4)(＞500个/μl比＜200个/μl:HR=0.42,95％CI:0.40 ～ 0.45).结论 1991-2017年四川省HIV/AIDS诊断后平均生存时间为11.51年.男性、小学及以下文化程度、汉族、农民、诊断时较大年龄、诊断时为艾滋病状态是HIV/AIDS生存的危险因素,接受ART、首次CD4水平高是HIV/AIDS生存的保护因素.

abstractsObjective To analyze the survival time of people living with HIV/AIDS and related influencing factors in Sichuan province during 1991-2017.Methods A retrospective cohort study was conducted to analyze the data of 143 988 HIV/AIDS cases.The data were collected from Chinese HIV/AIDS Comprehensive Information Management System.Life table method was used to calculate the survival proportion of the cases,and Cox proportion hazard regression model was used to identify the factors related with survival time.Results Among 143 988 HIV/AIDS cases a total of 30 420 cases died of AIDS related diseases (21.1％) and the average survival time was 11.51 years (95％CI:11.39-11.64).Multivariate Cox regression analysis showed that the influencing factors for the survival of HIV/AIDS cases were gender (male vs.female,HR=1.35,95％CI:1.32-1.40),education level (primary school or below vs.junior middle school:HR=1.15,95％CI:1.12-1.18),ethnic group (Han vs.other ethnic groups,HR=1.46,95％CI:1.41-1.52),occupation (farmer vs.other occupations:HR=1.26,95％CI:1.22-1.29),age (≥55 years old vs.15-24 years old:HR=3.18,95％CI:3.02-3.36),disease phase (AIDS vs.HIV infection:HR=1.44,95％ CI:1.39-1.48),antiretroviral therapy (ART) (receiving ART vs.receiving no ART:HR=0.20,95％CI:0.19-0.20),and CD4+T cell counts at diagnosis (＞500 cells/μl vs.＜200 cells/μl:HR=0.42,95％CI:0.40-0.45).Conclusions The average survival time of HIV/AIDS cases was 11.51 years in Sichuan during 1991-2017.The risk factors for the survival of the cases were male,education level of primary school or below,Han ethnic group,farmer,old age at diagnosis,disease phase,The protective factors for the survival of HIV/AIDS cases were receiving ART and higher CD4+ T cell counts at diagnosis.