Survival of AIDS patients in the emerging epidemic in Bangkok, Thailand.
Survival of AIDS patients in the emerging epidemic in Bangkok, Thailand.
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泰国曼谷新发流行病中艾滋病患者的生存情况。
DOI：
10.1097/00042560-199601010-00010
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发表时间：
1996
期刊：
影响因子：
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通讯作者：
T. Mastro
中科院分区：
文献类型：
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作者：
D. Kitayaporn;S. Tansuphaswadikul;P. Lohsomboon;K. Pannachet;J. Kaewkungwal;K. Limpakarnjanarat;T. Mastro
回顾性研究了1987年2月至1993年2月期间在泰国曼谷郊区一家公立三级传染病医院就诊的泰国患者（≥ 13岁）从艾滋病诊断到死亡的生存率。艾滋病的诊断是基于1987年疾病控制中心（CDC）的定义，除了马尔尼菲青霉菌感染被列为艾滋病的定义条件。在329例艾滋病患者中，152例（46.2%）死亡。诊断时的中位年龄为31.5岁（范围：18-74岁），306例患者（93.0%）为男性。报告的风险类别是异性接触（55.2%），注射毒品（IDU，22.6%），男性同性恋或双性恋接触（9.5%），和不明风险或其他（12.7%）。所有患者的中位生存时间（Kaplan-Meier）为7.0个月; 1年生存概率为39.2%（95%置信区间[CI] = 31.5-46.9%）。考克斯比例风险模型显示与生存相关的三个因素：年龄、报告的风险类别和诊断。年龄在26 - 35岁之间的患者存活时间更长（中位生存时间，10.6个月;相对危险度[RH] = 0.61，95% CI = 0.44-0.85，参照物：其他），性风险类别的患者也是如此（中位生存时间，7.3个月; RH = 0.59，95% CI = 0.40-0.78，参照物：IDU和其他类别）。肺外结核的单一诊断也与较长的生存期相关（中位生存期，19.9个月，RH = 0.55，95%CI = 0.35-0.86，参考：其他诊断）。在曼谷，艾滋病流行早期阶段的艾滋病患者的生存时间比发达国家的患者短得多，部分原因可能是他们往往在艾滋病毒感染过程的后期才被诊断出来。应加强对这些患者的早期诊断和治疗。
Survival from the time of AIDS diagnosis to death was determined retrospectively among Thai patients (> or = 13 years old) who attended a public tertiary care infectious disease hospital in a suburb of Bangkok, Thailand, from February 1987 through February 1993. An AIDS diagnosis was based on the 1987 Centers for Disease Control (CDC) definition, except Penicillium marneffei infection was included as an AIDS-defining condition. Of 329 AIDS patients, 152 (46.2%) had died. The median age at diagnosis was 31.5 years (range, 18-74) 306 patients (93.0%) were males. Reported risk categories were heterosexual contact (55.2%), injecting drug use (IDU, 22.6%), male homosexual or bisexual contact (9.5%), and unidentified risk or other (12.7%). Median survival time (Kaplan-Meier) for all patients was 7.0 months; 1-year survival probability was 39.2% (95% confidence interval [CI] = 31.5-46.9%). Cox's proportional hazards model showed three factors associated with survival: age, reported risk category, and presenting diagnosis. Patients aged 26 to 35 years survived longer (median survival time, 10.6 months; relative hazard [RH] = 0.61, 95% CI = 0.44-0.85, referent: others), as did patients in sexual risk categories (median survival time, 7.3 months; RH = 0.59, 95% CI = 0.40-0.78, referent: IDU and other categories). A single presenting diagnosis of extrapulmonary tuberculosis was also associated with longer survival (median survival time, 19.9 months, RH = 0.55, 95% CI = 0.35-0.86, referent: other diagnoses). AIDS patients in the early phase of the epidemic in Bangkok have much shorter survival times than patients in developed countries, in part perhaps because they are often diagnosed late in the course of HIV infection. Increased attention should be given to the early diagnosis and treatment of these patients.