背景:2009年在河南省引入了二线抗逆转录病毒治疗(ART)。开始这种治疗的患有人类免疫缺陷病毒(HIV)的人数正在增加。
目的:本研究旨在调查该组患者的生存率和影响死亡率的因素。
方法:我们对2010年5月1日至2016年5月1日期间转为二线ART的HIV感染者(PLHIV)进行了回顾性队列研究。,使用Kaplan-Meier方法和Cox比例风险模型。
结果:我们追踪了3,331PLHIV,持续了26,988人年,其中508人(15.3%)死亡。死亡率为1.88/100人年。在调整混杂因素后,我们发现是一个女人(危险比[HR],0.66;95%置信区间[CI]0.55-0.79),>50岁(HR,2.69;95CI,2.03-3.56),单/窗口(HR,1.26;95CI,1.04-1.52),拥有>6年的教育(HR,0.78;95CI,0.65-0.94),中医(HR,0.75;95CI,0.52-0.96),肝损伤(HR,1.58;95CI,1.19-2.10),和CD4+T细胞计数<200细胞/μl(HR,1.94;95CI,1.47-2.55),或200-350细胞/μl(HR,1.37;95CI,1.03-1.82)与死亡风险相关。
结论:我们发现转到二线ART的PLHIV患者的死亡率低于大多数以前的研究。回顾性队列的局限性可能,因此,有偏见的数据,需要前瞻性研究来确认结果。此外,中药联合二线ART显示出治疗HIV的潜力。
BACKGROUND: Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing.
OBJECTIVE: This study aimed to investigate the survival and factors affecting mortality among this group.
METHODS: We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan-Meier method and Cox proportional hazards models.
RESULTS: We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55-0.79), > 50 years old (HR, 2.69; 95% CI, 2.03-3.56), single/widowed (HR, 1.26; 95% CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52-0.96), liver injury (HR, 1.58; 95% CI, 1.19-2.10), and CD4+ T cell count <200 cells/μl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/μl (HR, 1.37; 95% CI, 1.03-1.82) were associated with mortality risk.
CONCLUSIONS: We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.