【摘要】 目的 了解山东省2013—2022年艾滋病病毒感染者和艾滋病病人(HIV/AIDS)的死亡趋势，并探讨相关影响因素。方法 以2013—2022年现住址为山东省的25 181例HIV/AIDS患者为研究对象，收集研究对象的人口学特征、抗病毒治疗以及死亡原因等信息，根据生存状况将患者分为存活、艾滋病相关死亡和非艾滋病相关死亡三组，采用Kruskal-Wallis检验、χ~2检验等进行组间比较，Joinpoint回归模型进行病死率趋势变化分析，并应用无序多分类logistic回归模型对HIV/AIDS患者死亡及其影响因素进行分析。结果 山东省2013—2022年共报告HIV/AIDS患者死亡病例1 187例，其中艾滋病相关死亡占34.63%,非艾滋病相关死亡占65.37%,病死率呈逐年下降趋势(APC分别为-13.58,-20.29和-9.67,均P<0.05)。无序多分类logistic回归分析结果显示：确诊到开始ART时间>30天、WHO临床分期为Ⅱ、Ⅲ和Ⅳ是HIV/AIDS患者发生艾滋病相关死亡的危险因素，OR(95%CI)值分别为1.74(1.41～2.16)、1.93(1.38～2.70)、2.61(1.87～3.63)和4.81(3.71～6.23);确诊到开始ART时间>30天、男性、农民和异性传播是HIV/AIDS患者发生非艾滋病相关死亡的危险因素，OR(95%CI)值分别为2.10(1.79～2.46)、1.75(1.38～2.20)、1.60(1.28～2.01)和1.75(1.48～2.08)。结论 2013—2022年山东省HIV/AIDS患者开始ART后病死率呈下降趋势，死亡年龄增加，发生非艾滋病相关死亡的病死率总体高于艾滋病相关死亡。艾滋病相关死亡和非艾滋病相关死亡的影响因素存在一定差异，应制定有针对性的干预措施。更多还原

【Abstract】 Objective To investigate the death trend of HIV/AIDS patients in Shandong Province from 2013 to 2022, andto explore the related influencing factors. Methods A total of 25 181 HIV/AIDS patients living in Shandong Province from 2013 to 2022 were selected as the study objects, demographic characteristics, antiretroviral therapy and causes of death were collected. Study objects were divided into three groups: survival, AIDS-related death and non-AIDS-related death. Kruskal-Wallis test and χ~2 test were conducted for inter group comparison, Joinpoint regression model was used to analyze the trend change of mortality, and unordered multicategorical logistic regression was used to analyze HIV/AIDS death and its influencing factors. Results From 2013 to 2022, a total of 1 187 HIV/AIDS patients deaths were reported in Shandong Province, among which AIDS-related deaths accounted for 34.63% and non-AIDS-related deaths accounted for 65.37%. The mortality rates showed a decreasing trend(APC was-13.58,-20.29, and-9.67, respectively, all P<0.05). Unordered multicategorical logistic regression analysis showed that the time from diagnosis to ART initiation greater than 30 days, WHO clinical stage Ⅱ, Ⅲ, and Ⅳ were the risk factors for AIDS-related death of HIV/AIDS patients, and the OR(95%CI) values were 1.74(1.41-2.16), 1.93(1.38-2.70), 2.61(1.87-3.63) and 4.81(3.71-6.23); the time from diagnosis to ART initiation greater than 30 days, male, farmer and heterosexual transmission were the risk factors for non-AIDS-related death of HIV/AIDS patients, with OR(95%CI) values of 2.10(1.79-2.46), 1.75(1.38-2.20), 1.60(1.28-2.01), and 1.75(1.48-2.08). Conclusion From 2013 to 2022, the case fatality rate of HIV/AIDS patients in Shandong Province has shown a downward trend after the start of ART, the age of death increased, and the case fatality rate of non-AIDS-related deaths is generally higher than that of AIDS-related deaths. There are differences in the influencing factors for AIDS-related and non-AIDS-related deaths, and targeted interventions should be developed.更多还原