Spatial Distribution Of Aids Patients And Survival Analysis After Antiviral Therapy In Hengyang City

Objective:To study the spatial distribution of AIDS in Hengyang City by using geographic information system,to explore the spatial aggregation of cases,to find out the epidemic focus areas and aggregation locations,and to provide decision support for AIDS prevention and control in prefectural and municipal areas from a spatial perspective.Based on the statistical analysis of AIDS patients receiving free treatment in Hengyang City,the basic characteristics,distribution and clinical characteristics of patients receiving antiretroviral treatment in Hengyang City were mastered;the survival status of AIDS patients receiving antiretroviral treatment in Hengyang City and its related influencing factors were discussed,and the appropriate AIDS prevention and control measures for Hengyang City were put forward to further improve AIDS in Hengyang City.The survival status of patients treated with antiviral therapy can provide reference for improving the effectiveness of antiviral treatment of AIDS in Hengyang.Methods:Data of AIDS patients from 2005 to 2017 were obtained from the medical record room of Hengyang Third People's Hospital.From2005 to 2017,the permanent population of Hengyang districts and counties at the end of the year was obtained from the Statistical Yearbook of Hengyang City,Hengyang Statistical Bureau.ArcGIS 10.2 was used to draw thematic map of AIDS infection,and OpenGeoda was used to analyze global spatial autocorrelation and local autocorrelation.Life table analysis was used to calculate the survival rate of AIDS patients after antiviral treatment,and Kaplan-Meier survival curve of each factor was drawn.Cox proportional risk model was used to explore the influencing factors of survival time after antiviral treatment.Results:The distribution of AIDS epidemic in Hengyang City was obvious in different districts and counties over the years,according to the spatial and temporal distribution of AIDS prevalence rate and cumulative number of reported AIDS cases.The morbidity rates of Nanyue District and Hengshan County in the four central districts of Hengyang City and the northern districts were higher than 60/100,000.It may be that the population flow in urban areas and Nanyue tourist areas is large and the economic level in the city is relatively high,which increases the possibility of AIDS infection.Global autocorrelation analysis showed that the incidence of AIDS in Hengyang City in past years had a positive spatial correlation.Local spatial autocorrelation analysis and hotspot analysis show that there is a high-high distribution pattern in the urban area and the southeastern Yueyue Circle.The survival rates of AIDS patients in Hengyang City in the first,third,fifth,seventh and ninth years from 2004to 2018 were 90.0%,84.0%,79.0%,77.0%and 73.0%respectively.Univariate analysis showed that gender,age,marital status,education level,route of infection,antiviral regimen,time from diagnosis to antiviral treatment(month),number of co-infection diseases,baseline CD4~+T lymphocyte count,viral inhibition effect and CD4~+T lymphocyte recovery were all influencing factors on the survival time of AIDS patients.Further multivariate analysis showed that age,route of infection,effect of virus suppression,recovery of CD4~+T lymphocyte,antiviral regimen,number of co-infectious diseases and baseline CD4~+T lymphocyte count were the influencing factors of survival time of AIDS patients.Conclusion:Since the first discovery of HIV infection in 1992,the number of AIDS reported in Hengyang City has been on the rise.Before2013,the rate of AIDS missing reports was high,and after 2013,the situation of missing reports has been alleviated.The majority of AIDS patients in Hengyang City are male,mainly over 30 years old.Their marital status is mainly married.The number of non-agricultural and farmers is more,more than half of them are heterosexual infections,the number of injecting drug users is more,the education level is lower,and the education level of junior middle school and below is more.The distribution of AIDS epidemic in Hengyang City has obvious regional characteristics.The central urban area of Hengyang City and Nanyue tourist area are high-incidence areas of AIDS,radiating to the surrounding areas in two major central areas.There was a significant positive spatial correlation between the AIDS epidemic in Hengyang City from 2005 to 2017,showing a clustered distribution.There are"hot spots"of AIDS incidence in 2012-2017.Among them,Hengdong County,Hengshan County and Nanyue District in the northeastern three districts of Hengyang City are the"hot spots"of AIDS incidence,while Xiangxiang District,Shigu District and Zhuhui District in the urban area are the"hot spots"of AIDS incidence.This study found that the death toll of AIDS patients in the first year of antiretroviral therapy in Hengyang City was the highest,suggesting that the first year is the key period affecting survival.The results showed that AIDS patients with fewer co-infections,higher baseline CD4~+T lymphocyte count,recovery of CD4~+T lymphocyte and more CD4~+T lymphocyte tests had a lower risk of death.