Survival from HIV-1 seroconversion in Southern Africa: a retrospective cohort study in nearly 2000 gold-miners over 10 years of follow-up
Survival from HIV-1 seroconversion in Southern Africa: a retrospective cohort study in nearly 2000 gold-miners over 10 years of follow-up
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DOI：
10.1097/qad.0b013e328017f857
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发表时间：
2007-03-12
期刊：
影响因子：
3.8
通讯作者：
Murray, Jill
中科院分区：
文献类型：
--
作者：
Glynn, Judith R.;Sonnenberg, Pam;Murray, Jill
目的：为了获得强有力的估计艾滋病毒的生存与已知的日期在非洲的血清转换在前antiretroviral earth.Design和方法：死亡率估计在一个回顾性队列研究与10年的随访，从南非的四个金矿的男性。艾滋病毒检测是在咨询和同意的情况下，在1990年代初的随机调查和诊所进行的。共有1950名血清转换间隔< 3年的HIV阳性男性与6164名随后没有HIV证据的HIV阴性男性进行了比较。独特的行业号码被用来将医疗记录与人口统计和职业信息联系起来。离开矿山后的后续行动进行了通过就业办公室在南部非洲，并使用南非的死亡登记data.Results：后续完成了85%的血清转化的人。总体中位生存期为10.5年：血清转换时15-24岁的患者为11.5年，25-34岁的患者为10.5年，35-44岁的患者为9.5年，45岁以上的患者为6.3年。与未感染艾滋病毒的矿工相比，相对死亡率迅速上升，感染艾滋病毒至少9年的矿工的相对死亡率达到13人，而且不因年龄组而异。超额死亡率随着年龄和感染持续时间的增加而增加，每年超过10%。调整血清转换时的年龄为25-29岁，5年生存率为89%，10年生存率为62%。讨论：本研究报告了迄今为止非洲已知血清转换日期的最大人群。在调整年龄后，存活模式与抗逆转录病毒治疗可用之前的西方相似。(c)2007年利平科特威廉姆斯&威尔金斯。
Objective: To obtain robust estimates of survival with HIV in individuals with known dates of seroconversion in Africa in the pre-antiretroviral era.Design and methods: Mortality rates were estimated in men from four South African gold mines in a retrospective cohort study with 10-year follow-up. HIV testing was carried out with counselling and consent, in random surveys in the early 1990s and in clinics. A total of 1950 HIV-positive men with seroconversion intervals < 3 years were compared with 6164 HIV-negative men with no subsequent evidence of HIV. Unique industry numbers were used to link medical records to demographic and occupational information. Follow-up after leaving the mine was conducted through employment offices across southern Africa, and using South African death registration data.Results: Follow-up was complete for 85% of those who seroconverted. Median survival was 10.5 years overall: 11.5 years for those aged 15-24 at seroconversion, 10.5 years for those aged 25-34, 9.5 years for those aged 35-44, and 6.3 years for those aged 45+ years. The relative mortality rate in comparison with HIV-uninfected miners increased quickly, reaching 13 for those HIV-infected for at least 9 years, and did not vary by age group. Excess mortality increased with age and duration of infection to > 10% per year. Adjusted to age 25-29 years at seroconversion, 5-year survival was 89% and 10-year 62%.Discussion: This study reports by far the largest cohort of individuals with known dates of seroconversion available in Africa. After adjusting for age, the survival pattern was similar to that seen in the West before antiretroviral therapy was available. (c) 2007 Lippincott Williams & Wilkins.