CAJ | 학술논문

目的了解静脉注射吸毒人群艾滋病毒(HIV)感染的生存与死亡规律及其影响因素.方法收集并分析云南省德宏州1989年8-12月发现的196例静脉注射吸毒HIV感染者20年跟踪随访资料.结果截止观察终点2009年12月31日,196例HIV感染者中177例(90.3%)死亡,10例(5.1%)存活,9例(4.6%)失访.总死亡密度为98.1/1000人年,艾滋病死亡密度为54.9/1000人年.因艾滋病死亡者占所有死亡者的55.9%,其他疾病死亡原因中以疟疾(2.8%)、败血症(2.3%)为主,非病死亡原因中以吸毒过量(13.0%)、意外伤亡(6.8%)为主.以死亡为结局,静脉注射吸毒人群HIV感染者中位生存时间为8.6年(95%CI:7.6～9.7).以艾滋病死亡为结局,则中位生存时间为11.3年(95%CI:10.3～12.8),估计的潜伏期约为10.3年.30岁及以上HIV感染者死亡的危险性是30岁以下者的1.9倍(95%CI:1.2～2.7).吸毒时间越长,生存时间越短(HR=0.7,95%CI:0.6～0.7).结论静脉注射吸毒人群非艾滋病死亡人数较多.注射吸毒人群中位生存时间和潜伏期低于发达国家同类人群.年龄是影响HIV感染生存时间的重要因素.
목적 료해정맥주사흡독인군애자병독(HIV)감염적생존여사망규률급기영향인소.방법 수집병분석운남성덕굉주1989년8-12월발현적196례정맥주사흡독HIV감염자20년근종수방자료.결과 절지관찰종점2009년12월31일,196례HIV감염자중177례(90.3%)사망,10례(5.1%)존활,9례(4.6%)실방.총사망밀도위98.1/1000인년,애자병사망밀도위54.9/1000인년.인애자병사망자점소유사망자적55.9%,기타질병사망원인중이학질(2.8%)、패혈증(2.3%)위주,비병사망원인중이흡독과량(13.0%)、의외상망(6.8%)위주.이사망위결국,정맥주사흡독인군HIV감염자중위생존시간위8.6년(95%CI:7.6～9.7).이애자병사망위결국,칙중위생존시간위11.3년(95%CI:10.3～12.8),고계적잠복기약위10.3년.30세급이상HIV감염자사망적위험성시30세이하자적1.9배(95%CI:1.2～2.7).흡독시간월장,생존시간월단(HR=0.7,95%CI:0.6～0.7).결론 정맥주사흡독인군비애자병사망인수교다.주사흡독인군중위생존시간화잠복기저우발체국가동류인군.년령시영향HIV감염생존시간적중요인소.
Objective To study the natural history of HIV-1 infection among intravenous drug users (IDUs) detected in late 1989 in the study area and the factors related to survival of these IDUs infected with HIV. Methods 196 injecting drug users first detected during August and December, 1989 were observed in Ruili county, Yunnan province. Data gathered from the 20-year follow-up program was collected and analyzed retrospectively. Results After 20 years' follow-up period, 90.3% of the 196 IDUs with HIV infection died, 5.1% of them were still alive, and 4.6% were lost. The crude pre-AIDS mortality rate was 98.1/1000 person-years, and the AIDS mortality rate was 54.9/1000 person-years. Malaria, septicemia were the main causes of death among the natural diseases whereas overdose and accidental causes were the principal causes related to those non-disease deaths.The median survival time from sero-conversion to death was 8.6 years (95%CI: 7.6-9.7). The median survival time from sero-conversion to death due to AIDS was 11.3 years (95%CI: 10.3-12.8) with the incubation time as around 10.3 years. People older than 30 years at seroconversion and length of drug usage were associated with shorter survival time, with hazards ratios as 1.9 and 0.7, respectively.Conclusion A high pre-AIDS mortality was observed among IDUs. Both the median survival time from sero-conversion to death and the HIV incubation period were shorter than that observed in the developed countries. Age of HIV infection seemed to have a strong effect on survival.