接受抗逆转录病毒治疗的结核感染艾滋病毒患者生存的统计建模:埃塞俄比亚巴希尔达尔费利格希沃特转诊医院一例

Senait Cherie Adegeh, E. Kebede
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摘要

目的:本研究的重点是建立在Felege Hiwot转诊医院接受抗逆转录病毒治疗的结核感染艾滋病毒患者的生存模型。方法:采用简单随机抽样的方法,选取年龄在15岁及以上的人类免疫缺陷病毒/结核病(HIV/TB)合并感染患者纳入研究。这项研究的样本量为314名患者。采用Kaplan-Meier生存曲线和Log-Rank检验比较不同类别患者的生存经验,采用比例风险Cox比例风险模型确定HIV/TB患者生存的独立预测因素。结果:死亡66例(21.0%),检出248例(79.0%)。单协变量分析结果显示,性别、年龄、婚姻状况、文化程度、就业状况、家庭规模、客厅数量、CD4计数、基线体重、WHO分期、治疗方案类型、ART知识、安全套使用情况、药物使用情况、饮酒情况、结核病类别和治疗方案改变是影响HIV/TB合并感染患者生存的因素,达到25%的显著水平。通过Cox回归分析,CD4计数、结核病种类、客厅数、就业状况、烟酒使用等独立因素具有显著性。不吸烟的患者的死亡风险比吸烟的患者低47.5%。结论:基线CD4计数、结核病种类、居住房间数、就业状况、烟酒使用情况是影响HIV/TB合并感染患者生存时间的主要因素。我们建议,应仔细监测CD4计数低、少于2个房间、弥散性和肺外结核、有饮酒和不就业等危险行为的患者,这是提高艾滋病毒/结核病合并感染患者生存率所必需的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Statistical Modeling of Survival of Tuberculosis Infected HIV Patients Treated with Antiretroviral Treatment: A Case of Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia
Objectives: This study focused on modeling of the survival of tuberculosis infected HIV patients treated with antiretroviral treatment in Felege Hiwot referral hospital. Methods: Human Immunodeficiency Virus/tuberculosis (HIV/TB) co-infected patients aged 15 years and above were selected using simple random sampling and included in the study. The sample size for this study was 314 patients. Kaplan-Meier survival curves and Log-Rank test were used to compare the survival experience of different category of patients, and proportional hazards Cox proportional hazards model was employed to identify independent predictors of survival of HIV/TB patients. Results: Of the total samples 66 (21.0%) were died and 248 (79.0%) were censored. The results of single covariate analysis show that the variables: sex, age, marital status, literacy status, employment status, family size number of living rooms, CD4 count, baseline body weight, WHO stage, regimen type, knowledge about ART, condom use, drug use, alcohol intake, tuberclosis category and regimen change were found to be factors that significantly influence the survival of HIV/TB co-infected patients at 25% significance level. From the Cox regression analysis, the independent factors CD4 count, tuberculosis category, number of living rooms, employment status, alcohol and tobacco use were significant. The odds of being at risk of death for patients who does not smoke tobacco is 47.5% less than those who use tobacco. Conclusions: In conclusion, baseline CD4 count, tuberculosis category, number of living rooms, employment status, alcohol and tobacco use were the main factors significantly influencing the survival time of HIV/TB co-infected patients. We recommend that, there should be a careful monitoring of patients with low CD4 count, less than two numbers of rooms, disseminated and extra-pulmonary TB, having risk behaviors like drinking alcohol and not being employed is necessary to improve survival of HIV/TB co-infected patients.
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