Survival of AIDS patients using two case definitions, Rio de Janeiro, Brazil, 1986-2003
Survival of AIDS patients using two case definitions, Rio de Janeiro, Brazil, 1986-2003
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DOI：
10.1097/01.aids.0000191486.92285.1c
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发表时间：
2005-10-01
期刊：
影响因子：
3.8
通讯作者：
Gadelha, AJ
中科院分区：
文献类型：
--
作者：
Campos, DP;Ribeiro, SR;Gadelha, AJ
背景：最近的研究表明，在发达国家和巴西，由于抗逆转录病毒治疗（ART）和预防机会性感染，艾滋病患者的生存率大幅提高。这项研究比较了巴西卫生部2004年和疾病控制和预防中心1993年在里约热内卢一个大型艾滋病毒/艾滋病转诊中心的病例定义的生存率。方法：采用Kaplan-Meier法和Cox比例风险模型，对1415名临床队列患者进行艾滋病诊断后的生存率评估。结果：393例（88%）死于艾滋病相关原因，52例（12%）死于非相关或未知原因。共有205例患者（14%）失去随访，765例患者（55%）存活至研究结束。四分之三的患者（75%）在根据CDC病例定义诊断出艾滋病后仍存活22个月[95%置信区间（Cl） 19-26]，根据卫生部病例定义存活31个月（95% Cl 26-36）。生存的独立预测指标包括由CD4细胞计数定义的艾滋病和任何使用高活性抗逆转录病毒疗法的情况，包括病例定义和病例的初始阶段，以及卫生部的病例定义。结论：尽管病例定义标准的选择影响了研究结果，但该参考中心观察到的生存期与其他国际研究相当或更长。采用卫生部的病例定义可加强跟踪艾滋病患者抗逆转录病毒治疗的使用情况和治疗结果的能力。(c) 2005年Lippincott Williams & Wilkins。
Background: Recent studies have shown substantial increases in the survival of AIDS patients in developed countries and in Brazil as a result of antiretroviral therapy (ART) and prophylaxis for opportunistic infections. This study compares survival rates using the Brazilian Ministry of Health 2004 and Centers for Disease Control and Prevention (CDC) 1993 case definitions in a large HIV/AIDS referral centre in Rio de Janeiro.Methods: Survival after AIDS diagnosis was assessed in a clinic-based cohort of 1415 individuals using the Kaplan-Meier method and Cox proportional hazards models.Results: There were 393 (88%) deaths from AIDS-related causes and 52 (12%) from unrelated or unknown causes. A total of 205 patients (14%) were lost to follow-up and 765 patients (55%) remained alive until the end of the study. Three-quarters of patients (75%) were still alive 22 months [95% confidence interval (Cl) 19-26] after the AIDS diagnosis according to the CDC case definition and 31 months (95% Cl 26-36) according to the Ministry of Health case definition. Independent predictors of survival included AIDS defined by CD4 cell count and any use of highly active antiretroviral therapy, with either case definition, and initial stage of the case, with the Ministry of Health case definition.Conclusion: Survival observed in this reference centre is comparable or longer than other international studies, although the choice of case definition criterion influenced findings. Adoption of the Ministry of Health case definition may enhance the ability to track the use of and outcomes from ART among AIDS patients. (c) 2005 Lippincott Williams & Wilkins.