纵向结果和竞争风险的联合建模:对艾滋病毒/艾滋病数据的应用
Khadijeh Najafi Ghobadi1, Hossein Mahjub1,2, Jalal Poorolajal3,4
1Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Journal of research in health sciences
|August 12, 2023
概括
艾滋病毒患者的CD4细胞数量下降显著增加了死亡的风险,但没有结核病 (TB) 感染. 结核病患者面临更高的死亡风险.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 结核病 (TB) 和人类免疫缺陷病毒 (HIV) 的联合感染对全球健康构成重大挑战.
- 艾滋病毒/结核病联合感染导致结核病发病率和死亡率高.
- CD4细胞计数是控制结核病/艾滋病毒联合感染的关键因素.
研究的目的:
- 为了确定风险因素和CD4细胞计数对结核病感染和艾滋病毒感染患者的艾滋病毒相关死亡的影响.
- 为了全面分析,利用纵向结果和竞争风险的联合模型.
主要方法:
- 追溯队列研究涉及1998-2019年期间的1436名HIV阳性患者.
- 应用联合建模来评估风险因素和CD4细胞对结核病和艾滋病毒相关死亡的影响.
主要成果:
- 减少CD4细胞计数与死亡风险增加相关,但结核病风险并非如此.
- 结核病患者死亡风险更高.
- 在CD4计数和性别,婚姻状况,教育,抗逆转录病毒疗法 (ART),时间和它们的相互作用之间发现了显著的关联. 艾滋病毒传播途径 (性接触,监禁,药物注射) 也影响了结核病风险.
结论:
- 减少CD4细胞数量是艾滋病毒相关死亡率增加的重要预测因素,独立于结核病风险.
- 结核病的同时感染增加了艾滋病毒阳性个体的死亡风险.
- 了解这些因素对于针对HIV/结核病同时感染的人群进行有针对性的干预至关重要.
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