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HIV/结核分枝杆菌双重感染者的生存时间及影响因素分析

段振华,  吴学庆,  施雅莹,  鹿茸,  范双凤,  李治军,  姜维华,  刘芳,  代珍,  何勤英

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文章导航 > 中华疾病控制杂志  > 2016 >  20(2): 180-183
段振华, 吴学庆, 施雅莹, 鹿茸, 范双凤, 李治军, 姜维华, 刘芳, 代珍, 何勤英. HIV/结核分枝杆菌双重感染者的生存时间及影响因素分析[J]. 中华疾病控制杂志, 2016, 20(2): 180-183. doi: 10.16462/j.cnki.zhjbkz.2016.02.019
引用本文: 段振华, 吴学庆, 施雅莹, 鹿茸, 范双凤, 李治军, 姜维华, 刘芳, 代珍, 何勤英. HIV/结核分枝杆菌双重感染者的生存时间及影响因素分析[J]. 中华疾病控制杂志, 2016, 20(2): 180-183. doi: 10.16462/j.cnki.zhjbkz.2016.02.019
shu
DUAN Zhen-hua, WU Xue-qing, SHI Ya-ying, LU Rong, FAN Shuang-feng, LI Zhi-jun, JIANG Wei-hua, LIU Fang, DAI Zhen, HE Qin-ying. Analysis on the survival time and influencing factors of HIV/mycobacterium tuberculosis-coinfected patients[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2016, 20(2): 180-183. doi: 10.16462/j.cnki.zhjbkz.2016.02.019
Citation: DUAN Zhen-hua, WU Xue-qing, SHI Ya-ying, LU Rong, FAN Shuang-feng, LI Zhi-jun, JIANG Wei-hua, LIU Fang, DAI Zhen, HE Qin-ying. Analysis on the survival time and influencing factors of HIV/mycobacterium tuberculosis-coinfected patients[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2016, 20(2): 180-183. doi: 10.16462/j.cnki.zhjbkz.2016.02.019
shu

HIV/结核分枝杆菌双重感染者的生存时间及影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2016.02.019

  • 成都市疾病预防控制中心性病与艾滋病防制科, 四川 成都 610041

基金项目: 

成都市科技惠民计划项目（2013年）

详细信息
    作者简介:

    段振华(1987-),男,湖北宣恩人,医师,硕士。主要研究方向:艾滋病流行病学。

  • 中图分类号: R181.2;R512.91

Analysis on the survival time and influencing factors of HIV/mycobacterium tuberculosis-coinfected patients

  • Department of AIDS and STD Control and Prevention, Chengdu Center for Disease Control and Prevention, Chengdu 610041, China

    摘要
  • 摘要: 目的 分析HIV/AIDS合并结核分枝杆菌感染病例的生存时间，并分析其影响因素。方法 采用回顾性队列研究方法，通过“艾滋病综合防治信息系统”收集HIV确证日期为2007年1月～2014年6月且在成都市报告或接受检测、随访服务的病例，筛选历次随访中“结核病检查结果”报告为“肺外结核”或“肺结核”的患者。采用Kaplan-Meier乘积极限法计算生存率，并采用单因素和多因素Cox比例风险回归模型分析双重感染者生存时间的影响因素。结果 583例双重感染者中，分别有278例（47.7%），469例（80.4%）在HIV确证后2个月、12个月内发现合并结核感染，HIV/AIDS在发现合并结核感染后1年生存率为79.6%。以随访发现合并结核感染为观察开始日期，截至2014年11月30日，共随访1 165.05人年，发生141例死亡，死亡密度达12.10人/100人年。多因素Cox风险比例回归模型分析结果显示，HIV确证时年龄（岁）越大者（HR=1.019，95% CI：1.003～1.035）、未进行抗病毒治疗者（HR=12.278，95% CI：7.918～19.038）和首次CD4+T淋巴细胞计数越低者（HR=1.712，95% CI：1.369～2.141）的死亡风险越高。同性传播感染（HR=0.334，95% CI：0.166～0.672）和异性传播感染（HR=0.328，95% CI：0.137～0.781）死亡风险低于非性途径传播感染病例。结论 HIV/AIDS病例合并结核感染主要在HIV确证后1年内随访发现，年龄、非性传播途径感染、未进行抗病毒治疗、首次CD4+T淋巴细胞计数低是双重感染者死亡的危险因素。
    Abstract: Objective To analyze the survival time and influencing factors of HIV/AIDS and mycobacterium tuberculosis (MTB)-coinfected patients in Chengdu, Sichuan Province. Methods Using retrospective cohort study method, through the China disease prevention and control information system of the subsystem “National AIDS Comprehensive Prevention and Control Information System”, the cases with confirmed date from January 2007 to June 2014 who lived or accepted detection/follow-up services in Chengdu were collected. All previous follow-up “tuberculosis test results” report for “extrapulmonary tuberculosis” or “tuberculosis patients” were screened”. The survival rate was calculated using the Kaplan-Meier method, and the univariate and multivariate Cox proportional hazards model were used for determining risk factors associated with survival time. Results A total of 583 HIV/MTB-coinfected patients were included in this study. 278(47.7%) and 469(80.4%) patients were found co-infected with MTB within 2 months and 12 months after HIV diagnosis. From the day of HIV/MTB co-infection reported to November 30, 2014, 141 patients died during 1 165.05 person-years of follow-up with the mortality rate of 12.10/100 person-years. In multivariate Cox analysis, HIV confirmatory age (years) (HR= 1.019, 95% CI:1.003-1.035), without ART (HR=12.278,95% CI: 7.918-19.038), the first CD4+T lymphocytes testing count (HR=1.712, 95% CI: 1.369-2.141) could affect the risk of all-cause mortality. Homosexual transmission (HR=0.334, 95% CI:0.166-0.672) and heterosexual transmission (HR=0.328, 95% CI: 0.137-0.781) (both compared with other transmission routes) were associated with reduced risk of HIV/MTB patients death. Conclusions HIV/AIDS cases with tuberculosis infection is mainly found in 1 year follow-up after the confirmation of HIV, the survival rate of amalgamative infection after 1 year lower than 80%. Age, non-sexually transmitted infection, not antiretroviral therapy, the low CD4+ T lymphocytes count of the first testing were the dominant risk factors of death in this region.
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  • 收稿日期:  2015-09-28
  • 修回日期:  2015-11-29

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