2003-2022 年中国四川省 PLWH 抗逆转录病毒治疗生存分析：大型回顾性队列研究

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-07-18 DOI:10.2147/idr.s463262

Li Ye, Xiwei Sun, Yiping Li, Yali Zeng, Lacuo Zhuoma, Dinglun Zhou, Qinying He, Ju Wang, Wei Yang, Hang Yu, Yihui Yang, Shu Liang, Dan Yuan

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Bilateral tests were performed, with P≤ 0.05 considered statistically significant. Results: The cumulative survival rates at 1, 3, 5, and 10 years for the 223,386 subjects were 94.54%, 89.07%, 84.82%, and 76.44%, respectively. Multivariate analysis using the Cox regression model indicated lower mortality risks for females (HR=0.59, 95% CI: 0.54– 0.65), homosexual transmission (HR=0.43, 95% CI: 0.33– 0.55), and baseline BMI≥ 24 (HR=0.81, 95% CI: 0.72– 0.90). Higher mortality risks were associated with age≥ 50 years at diagnosis (HR=3.21, 95% CI: 2.94– 3.50), being unmarried or divorced (HR=1.23, 95% CI: 1.11– 1.37), living separately (HR=1.32, 95% CI: 1.22– 1.43), baseline BMI < 18.5 (HR=1.27, 95% CI: 1.13– 1.41), presence of single-drug resistance (HR=1.25, 95% CI: 1.15– 1.36), baseline WHO stage IV (HR=1.27, 95% CI: 1.09– 1.47), and a diagnosis-to-treatment interval > 12 months (HR=1.27, 95% CI: 1.15– 1.41). Compared to those with CD4(+) T cell count of 200– 350cells/μL, 350– 500cells/μL, and > 500cells/μL at baseline, individuals with < 200cells/μL had higher mortality risks (HR=0.73, 95% CI: 0.67– 0.79; HR=0.57, 95% CI: 0.51– 0.64; and HR=0.58, 95% CI: 0.51– 0.66, respectively). Conclusion: The survival rate for PLWH receiving ART in Sichuan Province was relatively high. Male gender, age over 50 at diagnosis, being unmarried, divorced, or living separately, presence of single-drug resistance, low baseline BMI, baseline CD4+ T cell < 200cells/μL, baseline WHO stage IV, and a diagnosis-to-treatment interval > 12 months were risk factors for the survival of PLWH. 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引用次数: 0

摘要

研究背景四川省受艾滋病影响严重，有关四川省接受抗逆转录病毒疗法（ART）的艾滋病病毒感染者（PLWH）的生存时间和影响因素的数据十分匮乏，因此有必要对接受抗逆转录病毒疗法的艾滋病病毒感染者（PLWH）进行生存分析。因此，有必要对接受抗逆转录病毒疗法的艾滋病感染者进行生存分析：方法：对四川省自 2003 年 1 月 1 日至 2022 年 12 月 31 日接受抗逆转录病毒疗法≥6 个月的感染者进行了回顾性队列研究。研究采用 Kaplan-Meier 法计算中位生存时间并绘制生存曲线，同时采用 Cox 比例危险回归模型分析影响生存时间的因素。进行双侧检验，P≤0.05为差异有统计学意义：223,386名受试者的1年、3年、5年和10年累积生存率分别为94.54%、89.07%、84.82%和76.44%。使用 Cox 回归模型进行的多变量分析表明，女性（HR=0.59，95% CI：0.54- 0.65）、同性传播（HR=0.43，95% CI：0.33- 0.55）和基线体重指数≥ 24（HR=0.81，95% CI：0.72- 0.90）的死亡率风险较低。诊断时年龄≥ 50 岁（HR=3.21，95% CI：2.94- 3.50）、未婚或离异（HR=1.23，95% CI：1.11- 1.37）、分居（HR=1.32，95% CI：1.22- 1.43）、基线体重指数< 18.5（HR=1.27，95% CI：0.33- 0.55）与较高的死亡风险相关。5（HR=1.27，95% CI：1.13- 1.41）、存在单药耐药性（HR=1.25，95% CI：1.15- 1.36）、基线 WHO IV 期（HR=1.27，95% CI：1.09- 1.47）、诊断到治疗间隔 > 12 个月（HR=1.27，95% CI：1.15- 1.41）。与基线CD4（+）T细胞计数为200- 350cells/μL、350- 500cells/μL和> 500cells/μL的人相比，< 200cells/μL的人有更高的死亡风险（HR=0.73，95% CI：0.67- 0.79；HR=0.57，95% CI：0.51- 0.64；HR=0.58，95% CI：0.51- 0.66）：结论：四川省接受抗逆转录病毒疗法的感染者存活率相对较高。男性性别、确诊时年龄超过 50 岁、未婚、离异或分居、存在单药耐药性、低基线体重指数、基线 CD4+ T 细胞数为 200 cells/μL、基线 WHO IV 期、确诊至治疗间隔时间为 12 个月是影响 PLWH 存活率的危险因素。

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Survival Analysis of Antiretroviral Treatment for PLWH in Sichuan Province, China, 2003-2022: A Large Retrospective Cohort Study

Background: Sichuan Province was severely affected by the HIV, and there was a scarcity of data regarding the survival time and influencing factors for People Living with HIV/AIDS (PLWH) in Sichuan Province who have received Antiretroviral Therapy (ART). Therefore, it is necessary to conduct a survival analysis for PLWH receiving ART.
Methods: A retrospective cohort study was conducted on PLWH who had received ART≥ 6 months in Sichuan Province from January 1, 2003, to December 31, 2022. The Kaplan-Meier method was used to calculate median survival time and plot survival curves, while a Cox proportional hazards regression model was applied to analyze factors affecting survival time. Bilateral tests were performed, with P≤ 0.05 considered statistically significant.
Results: The cumulative survival rates at 1, 3, 5, and 10 years for the 223,386 subjects were 94.54%, 89.07%, 84.82%, and 76.44%, respectively. Multivariate analysis using the Cox regression model indicated lower mortality risks for females (HR=0.59, 95% CI: 0.54– 0.65), homosexual transmission (HR=0.43, 95% CI: 0.33– 0.55), and baseline BMI≥ 24 (HR=0.81, 95% CI: 0.72– 0.90). Higher mortality risks were associated with age≥ 50 years at diagnosis (HR=3.21, 95% CI: 2.94– 3.50), being unmarried or divorced (HR=1.23, 95% CI: 1.11– 1.37), living separately (HR=1.32, 95% CI: 1.22– 1.43), baseline BMI < 18.5 (HR=1.27, 95% CI: 1.13– 1.41), presence of single-drug resistance (HR=1.25, 95% CI: 1.15– 1.36), baseline WHO stage IV (HR=1.27, 95% CI: 1.09– 1.47), and a diagnosis-to-treatment interval > 12 months (HR=1.27, 95% CI: 1.15– 1.41). Compared to those with CD4(+) T cell count of 200– 350cells/μL, 350– 500cells/μL, and > 500cells/μL at baseline, individuals with < 200cells/μL had higher mortality risks (HR=0.73, 95% CI: 0.67– 0.79; HR=0.57, 95% CI: 0.51– 0.64; and HR=0.58, 95% CI: 0.51– 0.66, respectively).
Conclusion: The survival rate for PLWH receiving ART in Sichuan Province was relatively high. Male gender, age over 50 at diagnosis, being unmarried, divorced, or living separately, presence of single-drug resistance, low baseline BMI, baseline CD4+ T cell < 200cells/μL, baseline WHO stage IV, and a diagnosis-to-treatment interval > 12 months were risk factors for the survival of PLWH.

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.