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目的了解柳州市2010-2013年接受抗病毒治疗(antiretroviral treatment,ART)的老年(≥50岁)艾滋病(human immunodeficiency virus and acquired immunodeficiency syndrome,HIV/AIDS)患者的流行病学特征及生存情况。方法采用回顾性队列研究,对2010-2013年柳州市所有接受ART的老年HIV/AIDS进行描述性流行病学分析及生存分析。结果 494名研究对象中,HIV确诊年龄中位数为64岁(56~85岁),主要特征以男性、农民、已婚有配偶、小学及以下文化程度、异性传播途径感染为主。接受ART的老年HIV/AIDS中位生存时间为54个月,在第1~4年的累计生存率分别为99%、97%、95%、93%。多因素Cox比例风险回归模型分析显示,确诊年龄大、从确诊到开始治疗时间间隔较长是研究对象死亡的危险因素,入组治疗时CD4细胞较高是研究对象死亡的保护因素。结论柳州市老年HIV/AIDS总体ART效果较好,但仍需基于老年人群的流行特征加强艾滋病宣传教育及扩大检测力度,尤其是农村男性。
Objective To understand the epidemiological characteristics and survival of elderly patients (≥50 years old) with HIV / AIDS who received antiretroviral treatment (ART) in Liuzhou from 2010 to 2013. Methods A retrospective cohort study was conducted to provide a descriptive epidemiological analysis and survival analysis of all elderly HIV / AIDS ART patients in Liuzhou City from 2010 to 2013. Results Among 494 subjects, the median age at diagnosis of HIV was 64 years old (56-85 years old). The main characteristics of HIV infection were male, farmer, married spouse, primary school or below, and the infection of heterosexual transmission. The median survival time of elderly HIV / AIDS receiving ART was 54 months, with a cumulative survival of 99%, 97%, 95%, and 93%, respectively, in the first to fourth years. Multivariate Cox proportional hazards regression model analysis showed that the diagnosis of age, from the diagnosis to the beginning of a long time interval treatment of risk factors for the study of death, the higher CD4 cells into the treatment group is the study of death protective factors. Conclusion The overall ART effect of elderly HIV / AIDS in Liuzhou City is better overall. However, it is still necessary to strengthen HIV / AIDS publicity and education and expand the detection based on the epidemiological characteristics of elderly people, especially rural men.