Survival of persons with and without HIV infection in Denmark, 1995-2005
Survival of persons with and without HIV infection in Denmark, 1995-2005
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DOI：
10.7326/0003-4819-146-2-200701160-00003
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发表时间：
2007-01-16
影响因子：
39.2
通讯作者：
Obel, Niels
中科院分区：
文献类型：
--
作者：
Lohse, Nicolai;Hansen, Ann-Brit Eg;Obel, Niels
背景资料：HIV感染者的预期生存是主要的公共health interests.Objective：估计生存时间和年龄特异性死亡率的HIV感染人群相比，与一般population.Design：人口为基础的队列研究。设定：1995年至2005年在丹麦接受治疗的所有HIV感染者。患者：全国范围内的丹麦HIV队列研究的每个成员与多达99人从一般人群中根据性别，出生日期和municipalityofresidence.Measurements：作者计算Kaplan-Meier生命表，以年龄作为时间尺度，估计从25岁开始的生存率。从艾滋病毒感染者确诊之日起至死亡、移民或2005年5月1日，对艾滋病毒感染者和普通人群中的相应人员进行观察。3990名艾滋病病毒感染者和379872名普通人群被纳入研究，（中位数，5.8年/人）和2 689 287（中位数，8.4年/人）人-年的观察。3%的参与者失访。从25岁开始，HIV感染患者的中位生存期为19.9年（95% CI，18.5 - 21.3），普通人群为51.1年（CI，50.9 - 51.5）。在2000年至2005年期间，艾滋病毒感染者的生存期增加到32.5年（置信区间，29.4至34.7年）。在排除已知丙型肝炎合并感染者（16%）的亚组中，同期的中位生存期为38.9年（CI，35.4 - 40.1）。与一般人群相比，HIV感染患者的相对死亡率随着年龄的增长而下降，而超额死亡率随着年龄的增长而增加。局限性：假设观察到的死亡率适用于当前最长观察时间10年之后。结论：在晚期高效抗逆转录病毒治疗时代，被诊断感染艾滋病毒的年轻人的估计中位生存期超过35年。然而，仍需不断努力，以进一步降低这些人与一般人口相比的死亡率。
Background: The expected survival of HIV-infected patients is of major public health interest.Objective: To estimate survival time and age-specific mortality rates of an HIV-infected population compared with that of the general population.Design: Population-based cohort study. Setting: All HIV-infected persons receiving care in Denmark from 1995 to 2005.Patients: Each member of the nationwide Danish HIV Cohort Study was matched with as many as 99 persons from the general population according to sex, date of birth, and municipality of residence.Measurements: The authors computed Kaplan-Meier life tables with age as the time scale to estimate survival from age 25 years. Patients with HIV infection and corresponding persons from the general population were observed from the date of the patient's HIV diagnosis until death, emigration, or 1 May 2005.Results: 3990 HIV-infected patients and 379 872 persons from the general population were included in the study, yielding 22 744 (median, 5.8 y/person) and 2 689 287 (median, 8.4 years/person) person-years of observation. Three percent of participants were lost to follow-up. From age 25 years, the median survival was 19.9 years (95% CI, 18.5 to 21.3) among patients with HIV infection and 51.1 years (CI, 50.9 to 51.5) among the general population. For HIV-infected patients, survival increased to 32.5 years (CI, 29.4 to 34.7) during the 2000 to 2005 period. In the subgroup that excluded persons with known hepatitis C coinfection (16%), median survival was 38.9 years (CI, 35.4 to 40.1) during this same period. The relative mortality rates for patients with HIV infection compared with those for the general population decreased with increasing age, whereas the excess mortality rate increased with increasing age.Limitations: The observed mortality rates are assumed to apply beyond the current maximum observation time of 10 years.Conclusions: The estimated median survival is more than 35 years for a young person diagnosed with HIV infection in the late highly active antiretroviral therapy era. However, an ongoing effort is still needed to further reduce mortality rates for these persons compared with the general population.