中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2012年
3期
153-157
,共5页
邓莉平%桂希恩%熊勇%高世成%荣玉萍%杨蓉蓉%胡锦枝
鄧莉平%桂希恩%熊勇%高世成%榮玉萍%楊蓉蓉%鬍錦枝
산리평%계희은%웅용%고세성%영옥평%양용용%호금지
HIV%丙型肝炎病毒%联合抗反转录病毒治疗%死亡%危险因素
HIV%丙型肝炎病毒%聯閤抗反轉錄病毒治療%死亡%危險因素
HIV%병형간염병독%연합항반전록병독치료%사망%위험인소
HIV%Hepatitis C virus%Combined antiretroviral therapy%Death%Risk factors
目的 了解开展联合抗反转录病毒治疗(combined antiretroviral therapy,cART)后湖北省HIV/HCV合并感染者死亡情况及相关的危险因素.方法 回顾性研究2003年1月—2010年12月在武汉大学中南医院就诊或在当地疾病预防控制中心会诊的427例HIV/HCV合并感染者的人口学和临床资料.采用Cox逐步回归模型分析死亡发生的相关因素；Kaplan-Meier方法分析晚期肝病对HIV/HCV合并感染者死亡的影响.结果 427例HIV/HCV合并感染者随访期间53例患者死亡,病死率为12.4％,其中28例(52.8％)死于肝病相关的疾病.男性患者(RR=2.63,P=0.05),受血感染(RR=2.15,P=0.04),基线CD4+T细胞计数＜50个/μL(RR=2.83,P=0.02),随访结束时HIV RNA载量≥104拷贝/mL( RR=2.79,P=0.00)及并发终末期肝病(RR =7.79,P=0.00)与死亡显著相关,而cART持续时间＞5年是死亡的保护因素(RR =0.03,P=0.00).合并晚期肝病者的病死率高达52.7％(29/55).结论 肝病已成为HIV/HCV合并感染者死亡的主要原因,出现晚期肝病者死亡的风险高.
目的 瞭解開展聯閤抗反轉錄病毒治療(combined antiretroviral therapy,cART)後湖北省HIV/HCV閤併感染者死亡情況及相關的危險因素.方法 迴顧性研究2003年1月—2010年12月在武漢大學中南醫院就診或在噹地疾病預防控製中心會診的427例HIV/HCV閤併感染者的人口學和臨床資料.採用Cox逐步迴歸模型分析死亡髮生的相關因素；Kaplan-Meier方法分析晚期肝病對HIV/HCV閤併感染者死亡的影響.結果 427例HIV/HCV閤併感染者隨訪期間53例患者死亡,病死率為12.4％,其中28例(52.8％)死于肝病相關的疾病.男性患者(RR=2.63,P=0.05),受血感染(RR=2.15,P=0.04),基線CD4+T細胞計數＜50箇/μL(RR=2.83,P=0.02),隨訪結束時HIV RNA載量≥104拷貝/mL( RR=2.79,P=0.00)及併髮終末期肝病(RR =7.79,P=0.00)與死亡顯著相關,而cART持續時間＞5年是死亡的保護因素(RR =0.03,P=0.00).閤併晚期肝病者的病死率高達52.7％(29/55).結論 肝病已成為HIV/HCV閤併感染者死亡的主要原因,齣現晚期肝病者死亡的風險高.
목적 료해개전연합항반전록병독치료(combined antiretroviral therapy,cART)후호북성HIV/HCV합병감염자사망정황급상관적위험인소.방법 회고성연구2003년1월—2010년12월재무한대학중남의원취진혹재당지질병예방공제중심회진적427례HIV/HCV합병감염자적인구학화림상자료.채용Cox축보회귀모형분석사망발생적상관인소；Kaplan-Meier방법분석만기간병대HIV/HCV합병감염자사망적영향.결과 427례HIV/HCV합병감염자수방기간53례환자사망,병사솔위12.4％,기중28례(52.8％)사우간병상관적질병.남성환자(RR=2.63,P=0.05),수혈감염(RR=2.15,P=0.04),기선CD4+T세포계수＜50개/μL(RR=2.83,P=0.02),수방결속시HIV RNA재량≥104고패/mL( RR=2.79,P=0.00)급병발종말기간병(RR =7.79,P=0.00)여사망현저상관,이cART지속시간＞5년시사망적보호인소(RR =0.03,P=0.00).합병만기간병자적병사솔고체52.7％(29/55).결론 간병이성위HIV/HCV합병감염자사망적주요원인,출현만기간병자사망적풍험고.
Objective To analyze the incidence,mortality and risk factors of death in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients with combined antiretroviral therapy (cART).Methods A total of 427 HIV/HCV co-infected patients admitted to Zhongnan Hospital of Wuhan University or local disease prevention and control canters from January 2003 to December 2010 were enrolled in the study.The demographic and clinical data of patients were retrospectively studied.Cox progressive regression model was used for data analysis,and Kaplan-Meier method was used to evaluate the effect of end-stage liver diseases on the death.Results of 427 HIV/HCV co-infected patients,53 ( 12.4％ ) died during the follow-up,in which 28 (52.8％) died of liver-related diseases.Male gender ( RR =2.63,P =0.05 ),infection via blood transfusion ( RR =2.15,P =0.04),baseline CD4 + T cells ＜50 cells/μL ( RR =2.83,P =0.02),HIV RNA≥ 104copies/mL at the end of follow-up (RR =2.79,P =0.00 ) and complicated with end-stage liver disease ( RR =7.79,P =0.00) were significantly related to the death.Duration of cART ＞ 5 years is a protective factor for the death ( RR =0.03,P =0.00).Themortality of patients complicated with end-stage liver diseases was 52.7％ ( 29/55 ).Conclusion Liver disease-related death has become the leading cause of death in HIV/HCV co-infected patients,and patients with end-stage liver diseases are of high risk of death.
