艾滋病毒血清转换后死亡风险的变化与一般人口的死亡率相比
Krishnan Bhaskaran1, Osamah Hamouda, Mette Sannes
1MRC Clinical Trials Unit, 222 Euston Rd, London NW1 2DA, United Kingdom. kp@ctu.mrc.ac.uk
JAMA
|July 3, 2008
概括
人类免疫缺陷病毒 (HIV) 感染者的死亡率显著下降,在有效治疗的情况下接近一般人口水平. 然而,随着感染持续时间的延长,死亡率差距仍然存在.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染者的死亡率在获得治疗的地区急剧下降.
- 艾滋病毒感染者与普通人口之间的死亡率差距正在缩小.
研究的目的:
- 评估HIV感染者与一般未感染人口之间的死亡率差距随着时间的推移而发生的变化.
- 评估高活性抗逆转录病毒疗法 (HAART) 对死亡率差异的影响.
主要方法:
- 利用了来自HIV血清转换器队伍的CASCADE合作的数据.
- 艾滋病毒感染个体的死亡率与一般人口的预期死亡率的比较,根据人口统计因素进行匹配.
- 采用基于Poisson的模型来分析1981-2006年感染持续时间调整后的过度死亡率变化.
主要成果:
- 每1000人/年的过度死亡率从1996年之前的40.8下降到2004-2006年的6.1.
- 观察到过度危险比率的显著降低,从1996年之前的水平降至2004年至2006年的0.05.
- 在2004-2006年,在性感染个体的血清转换后的前5年内,没有观察到过度死亡率,尽管长期死亡的过度概率仍然存在.
结论:
- 引入HAART已大大降低了艾滋病毒感染者的死亡率,使其更接近一般人口的死亡率.
- 在工业化国家,感染性艾滋病毒的个体在感染后的前5年内,死亡率与一般人口相似.
- 随着艾滋病毒感染持续时间的增加,观察到持续的过度死亡风险.
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