【摘要】 目的评估抗病毒治疗(ART)成人艾滋病病例的效果,分析其主要影响因素。方法采用回顾性队列研究方法,选择山西南部4市2004年6月底至2012年12月底纳入国家免费抗病毒治疗系统的病例,收集资料补充调查,使用SPSS19.0进行统计分析。结果 1887例抗病毒治疗病例,存活率为83.1%,死亡率为13.5%,停药率为1.4%,转诊率为1.2%,失访率为0.8%;治疗后第0.5、1、2、3、4、5、6、7和8年累计生存率分别为0.91、0.89、0.88、0.86、0.85、0.82、0.80、0.79和0.79;CD4+T淋巴细胞从ART前的143.5个/μL平均增加205.3个/μL,治疗前后<100个/μL的比例由41.4%下降至7.8%、>350个/μL的比例由0.9%上升至46.7%。病毒载量治疗前<LDL占18.2%,治疗后提高到89.1%;Cox比例风险回归模型多因素分析发现,ART前CD4+T淋巴细胞计数、ART时年龄、ART前BMI 3个变量的分组与生存时间差异分别有统计学意义。死亡危险比(HR)分别为4.05、3.68、3.44。结论抗病毒治疗取得了较好的治疗效果。更多还原

【Abstract】 Objective To evaluate the effectiveness of free antiretroviral therapy(ART) for adults AIDS patients and the factors influence ART outcome. Methods A retrospective cohort study was conducted in 4 cities in southern Shanxi province. All qualified ART recipients were enrolled in the national free ART program from Jun 2004 to Dec 2012.Statistical analysis was conducted by SPSS software(version19.0). Results Among 1887 treated cases, the survival rate was83.1%, the mortality rate was 13.5%, the drug withdrawal rate was 1.4%, the transfer treatment rate was 1.2% and the rate of loss to follow-up was 0.8%. The cumulative survival rates were 0.91, 0.89, 0.88, 0.86, 0.85, 0.82, 0.80, 0.79 and 0.79 at 0.5, 1, 2, 3, 4, 5, 6, 7 and 8 years after treatment initiation, respectively. The medians of CD4+ T cell count were 143cells/μL prior to treatment and 205 cells/μL post treatment. 18.2% of ART recipients had their viral loads below detection limit before therapy and this percentage increased to 89.1% after therapy. In the multivariate COX proportional hazard model, CD4+ T cell count and BMI before treatment initiation, and the age start therapy were significantly associated with survival time. The Hazard ratios were 4.05, 3.44 and 3.68, respectively. Conclusion The ART treatment has been successfully implemented with the significant improvement on immune system and containment of viral replication.更多还原