摘要
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HIVRNA载量≥10^4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。
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≥ 10^4eopies/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 ）. The mortality 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.
出处
《中华临床感染病杂志》
CAS
2012年第3期153-157,共5页
Chinese Journal of Clinical Infectious Diseases
