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目的了解贵州省男男性行为者(MSM)中的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人),在接受抗艾滋病病毒治疗(ART)后的生存时间及其影响因素。方法回顾性分析贵州省2006年至2015年接受抗病毒治疗的MSM HIV/AIDS病人的生存时间,计算累计生存概率,运用COX回归分析其影响因素。结果共收集MSM HIV/AIDS病人1 671例,开始治疗时的年龄为14~72(30.6±9.5)岁,未婚占73.3%(1225/1 671)。治疗后病人的随访时间M=16.0(QR:6.0~33.0)个月。在发生死亡的49例中,有63.3%(31/49)的病人在开始治疗后的6个月内死亡;第1、3、5年的累计生存率分别为0.98、0.96和0.95。多因素COX回归结果显示:病人开始治疗时年龄越小死亡风险越大;开始治疗时的CD4+T淋巴细胞计数越低死亡风险越大;治疗前患有肺结核、有疾病症状体征的病人死亡风险更高。结论抗病毒治疗延长了MSM AIDS病人的生存时间。建议针对年龄小、CD4+T淋巴细胞计数低、治疗前患有肺结核或已有疾病症状体征的病人,加强临床诊疗和医学随访。
Objective To understand the survival time of HIV / AIDS patients (HIV / AIDS patients) in MSM of Guizhou Province and its effect after receiving anti-HIV treatment (ART) factor. Methods The survival time of MSM HIV / AIDS patients receiving antiretroviral therapy from 2006 to 2015 in Guizhou Province was retrospectively analyzed. The cumulative survival probability was calculated and the influencing factors were analyzed by COX regression. Results A total of 1 671 MSM HIV / AIDS patients were collected. The age at onset of treatment was 14-72 (30.6 ± 9.5) years and unmarried 73.3% (1225/1 671). The follow-up time of patients after treatment was M = 16.0 (QR: 6.0 ~ 33.0) months. Among the 49 deaths, 63.3% (31/49) died within 6 months after initiation of treatment; the cumulative survival rates at 1, 3 and 5 years were 0.98, 0.96 and 0.95, respectively. Multivariate Cox regression showed that the younger the patient was, the lower the risk of death was. The lower the CD4 + T lymphocyte count at the start of treatment was, the greater the risk of death. The risk of death from tuberculosis and symptoms and signs before treatment higher. Conclusion Antiviral therapy prolongs the survival of MSM AIDS patients. It is suggested that clinical diagnosis and medical follow-up should be strengthened for patients with small age, low CD4 + T lymphocyte count, patients with tuberculosis or symptoms and signs of the disease before treatment.