中国不同性别成人艾滋病抗病毒治疗效果的差异
发布时间：2018-08-01 14:02
【摘要】：目的探索我国不同性别的成人HIV感染者/AIDS患者抗病毒治疗效果的差异,评价性别对病毒抑制率、治疗保持率和病死率的影响,为明确发展中地区成人HIV感染者/AIDS患者的性别对抗病毒治疗效果的影响及进一步明确不同性别抗病毒治疗效果差异的原因提供研究依据。方法使用国家免费抗病毒治疗数据库中的防治数据进行回顾性队列研究。将2010年1月1日至2011年12月31日期间初次开始抗病毒治疗的、18岁以上、以推荐一线治疗方案为初始治疗方案的HIV感染者/AIDS患者作为研究对象,随访观察4年,研究终止时间为2015年12月31日。用Logistic回归进行总体和分层分析,比较不同性别在治疗12个月及48个月后病毒抑制率、治疗保持率的差异,用Kaplan-Meier.法和Cox比例风险模型进行总体和分层分析,比较不同性别病死率的差异。纳入分析的因素还包括年龄、体重指数、地区、婚姻状况、感染途径、基线CD4细胞计数、初始治疗方案、诊断HIV感染至开始治疗时间。用SAS9.3软件进行数据处理和统计分析。结果共68646名患者被纳入研究,其中67.1%(46083名)为男性患者,32.9%(22563名)为女性患者。总体分析结果表明,女性患者在治疗12个月后(校正OR:1.13,95%CI:1.06-1.21)及 48 个月后(校正 OR:1.10,95%CI:1.01-1.20)都比男性患者更易达到病毒抑制。女性患者在治疗12个月后(校正OR:1.15,95%CI:1.08-1.23)及治疗48个月后(校正OR:1.22,95%CI:1.15-1.29)比男性患者更易保持治疗。所有研究对象治疗4年的病死率为3.45/100人年,其中女性患者病死率低于男性患者(2.34 vs.4.03/100人年),女性患者死亡风险更小(校正HR:0.71,95%CI:0.66-0.76)。分层分析结果表明,开始治疗年龄18-44岁、农村、经血液传播/既往献血感染、经注射吸毒感染、基线CD4细胞计数200-349个/μ L、诊断至开始治疗时间大于3个月的患者中女性治疗12个月及48个月病毒抑制率均高于男性。结论本研究发现我国接受抗病毒治疗的女性患者比男性患者更易达到病毒抑制、更易保持治疗,女性患者的病死率也明显低于男性患者。今后可以进一步开展研究探索导致抗病毒治疗效果性别差异的原因、探索性别对服药依从性的影响等。
[Abstract]:Objective to explore the effect of antiviral therapy on HIV / AIDS patients of different genders in China, and to evaluate the effect of sex on viral inhibition rate, treatment retention rate and mortality rate. In order to clarify the effect of gender antiviral therapy in adult patients with HIV / AIDS in developing areas and to further clarify the reasons for the difference of the effect of anti-virus therapy between different sexes. Methods A retrospective cohort study was conducted using the prevention and treatment data from the national free antiviral therapy database. From January 1, 2010 to December 31, 2011, the patients over 18 years of age who first began antiviral therapy between January 1, 2010 and December 31, 2011, were followed up for 4 years. The study was terminated on December 31, 2015. The overall and stratified analysis with Logistic regression was used to compare the difference of virus inhibition rate and treatment retention rate between different genders after 12 and 48 months of treatment. Kaplan-Meier was used. Method and Cox proportional risk model were used to analyze the overall and stratified mortality. Factors included in the analysis included age, body mass index, region, marital status, route of infection, baseline CD4 cell count, initial treatment regimen, and diagnosis of HIV infection to the beginning of treatment. Data processing and statistical analysis are carried out with SAS9.3 software. Results A total of 68646 patients were included in the study, of which 67.1% (46083) were male and 32.9% (22563) were female. The overall analysis showed that female patients were more likely than male patients to achieve viral suppression 12 months after treatment (adjusted OR: 1.1395CI: 1.06-1.21) and 48 months later (adjusted OR: 1.1095 CI: 1.01-1.20). Female patients were more likely to maintain treatment than male patients after 12 months of treatment and 48 months of treatment (OR: 1.2295 CI: 1.15-1.29). The mortality of all subjects was 3.45 / 100 person-years. The mortality of female patients was lower than that of male patients (2.34 vs.4.03/100 person-years), and the risk of death of female patients was lower than that of male patients (adjusted HR0.7195 CI: 0.66-0.76). The results of stratified analysis showed that patients aged 18-44 years, who started treatment in rural areas, were infected by blood transmission / blood donation, and were infected by injecting drug use. The baseline CD4 cell counts of 200-349 cells / 渭 L were significantly higher in women than in men at 12 and 48 months of treatment for more than 3 months from the diagnosis to the beginning of treatment. Conclusion this study found that female patients receiving antiviral therapy were more likely to achieve viral inhibition and maintain treatment than male patients, and the mortality of female patients was significantly lower than that of male patients. Further research can be carried out to explore the causes of gender differences in antiviral efficacy and the effect of exploratory differences on drug compliance.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91
本文编号：2157808
[Abstract]:Objective to explore the effect of antiviral therapy on HIV / AIDS patients of different genders in China, and to evaluate the effect of sex on viral inhibition rate, treatment retention rate and mortality rate. In order to clarify the effect of gender antiviral therapy in adult patients with HIV / AIDS in developing areas and to further clarify the reasons for the difference of the effect of anti-virus therapy between different sexes. Methods A retrospective cohort study was conducted using the prevention and treatment data from the national free antiviral therapy database. From January 1, 2010 to December 31, 2011, the patients over 18 years of age who first began antiviral therapy between January 1, 2010 and December 31, 2011, were followed up for 4 years. The study was terminated on December 31, 2015. The overall and stratified analysis with Logistic regression was used to compare the difference of virus inhibition rate and treatment retention rate between different genders after 12 and 48 months of treatment. Kaplan-Meier was used. Method and Cox proportional risk model were used to analyze the overall and stratified mortality. Factors included in the analysis included age, body mass index, region, marital status, route of infection, baseline CD4 cell count, initial treatment regimen, and diagnosis of HIV infection to the beginning of treatment. Data processing and statistical analysis are carried out with SAS9.3 software. Results A total of 68646 patients were included in the study, of which 67.1% (46083) were male and 32.9% (22563) were female. The overall analysis showed that female patients were more likely than male patients to achieve viral suppression 12 months after treatment (adjusted OR: 1.1395CI: 1.06-1.21) and 48 months later (adjusted OR: 1.1095 CI: 1.01-1.20). Female patients were more likely to maintain treatment than male patients after 12 months of treatment and 48 months of treatment (OR: 1.2295 CI: 1.15-1.29). The mortality of all subjects was 3.45 / 100 person-years. The mortality of female patients was lower than that of male patients (2.34 vs.4.03/100 person-years), and the risk of death of female patients was lower than that of male patients (adjusted HR0.7195 CI: 0.66-0.76). The results of stratified analysis showed that patients aged 18-44 years, who started treatment in rural areas, were infected by blood transmission / blood donation, and were infected by injecting drug use. The baseline CD4 cell counts of 200-349 cells / 渭 L were significantly higher in women than in men at 12 and 48 months of treatment for more than 3 months from the diagnosis to the beginning of treatment. Conclusion this study found that female patients receiving antiviral therapy were more likely to achieve viral inhibition and maintain treatment than male patients, and the mortality of female patients was significantly lower than that of male patients. Further research can be carried out to explore the causes of gender differences in antiviral efficacy and the effect of exploratory differences on drug compliance.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91
【参考文献】
相关期刊论文 前7条
1 ;2016年12月全国艾滋病性病疫情[J];中国艾滋病性病;2017年02期
2 倪明健;陈学玲;马媛媛;胡晓远;;新疆维吾尔自治区艾滋病抗病毒治疗者不同性别死亡率及其影响因素分析[J];中华流行病学杂志;2015年09期
3 赵德才;马烨;张福杰;宫伟彦;房华;赵燕;刘霞;孙鑫;豆智慧;于兰;刘中夫;李言飞;;基于客户端/服务器结构的中国艾滋病抗病毒治疗信息系统的升级改造[J];中国艾滋病性病;2013年06期
4 刘玉芬;李晓春;高丽;王丽艳;邱光平;王春泉;罗跃光;张小波;王璐;;女性艾滋病病毒感染者和患者生存质量及影响因素调查[J];中国妇幼保健;2010年18期
5 马烨;王建生;张福杰;于兰;文毅;赵燕;;中国艾滋病抗病毒药物治疗信息系统的建立与现况[J];中国艾滋病性病;2006年05期
6 Jennifer PAN;;Current progress of China’s free ART program[J];Cell Research;2005年Z1期
7 张福杰,文毅,于兰,马烨,潘捷,赵燕;艾滋病的抗病毒治疗与我国的免费治疗现状[J];科技导报;2005年07期
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