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Anne M Neilan^1,2,3,4, Ogochukwu L Ufio², Isaac Ravi Brenner²

¹Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston.

JAMA health forum

|May 10, 2024

概括

艾滋病毒感染的青少年的预期寿命比他们的HIV阴性同龄人更短. 这种差异在患有非围产期获得的艾滋病毒 (NPHIV) 与围产期获得的艾滋病毒 (PHIV) 的人群中更为明显.

科学领域:

公共卫生公共卫生
流行病学流行病学
生物统计学生物统计学

背景情况:

预期寿命是人口健康的关键指标.
估计美国艾滋病毒感染青年的预期寿命对于为健康政策和资源分配提供信息至关重要.
目前的艾滋病毒护理和治疗背景需要更新青少年的预期寿命数据.

研究的目的:

为了比较18岁的年轻人的预期寿命,与周产期获得的艾滋病毒 (PHIV),非周产期获得的艾滋病毒 (NPHIV) 和没有艾滋病毒.
评估艾滋病毒感染时间对预计寿命的影响.
评估潜在的预期寿命增长与理想的艾滋病毒护理场景.

主要方法:

美国专注,青少年特定的蒙特卡洛状态过渡HIV模型被利用.
模拟追踪了从18岁到死亡的个体,并结合了护理参与的概率,疾病进展和死亡率.
输入参数来自观察队列和临床试验,种族/种族和风险因素在各组之间匹配.

主要成果:

与没有艾滋病毒的年轻人相比,患有PHIV的年轻人经历了预计寿命减少10.4-11.8年.
患有NPHIV的年轻人面临着更大的预期寿命损失15.0-19.5年.
理想的艾滋病毒治疗可以改善PHIV年轻人的预期寿命 (损失0.5-0.6年),但对NPHIV年轻人的显著损失仍然存在 (损失6.0-10.4年).

结论:

针对青少年的建模表明,与没有艾滋病毒的人相比,艾滋病毒感染的青少年的预期寿命缩短了.
与艾滋病毒感染 (NPHIV与PHIV) 相关的死亡率差异,出生时的性别,性行为和注射药物使用有助于这些差异.
针对艾滋病毒护理和社会决定因素的有针对性的干预措施对于提高美国艾滋病毒感染年轻人的预期寿命至关重要.

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