摘要
目的探讨大气细颗粒物(fine particulate matter,PM_(2.5))及其组分暴露对男性人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者疾病进展的影响情况,并识别脆弱人群。方法选取2000―2021年在武汉市艾滋病(acquired immunodeficiency syndrome,AIDS)综合响应信息管理系统中新报告的男性HIV感染者作为研究对象。运用Fine-Gray竞争风险生存分析、分位数g计算模型以及交互效应模型评估大气PM_(2.5)及其组分暴露对男性HIV感染者疾病进展的影响,识别PM_(2.5)中的关键毒性组分、探寻脆弱人群。结果共纳入5571名新报告的男性HIV感染者,随访期间1151名研究对象进展为AIDS,发生率为69.10/1000人年。Fine-Gray竞争风险生存分析结果显示,大气PM_(2.5)的累积平均暴露浓度每增加10μg/m^(3),AIDS的发生风险增加28.8%(95%CI:25.5%~32.2%);PM_(2.5)组分中有机物、黑碳、铵盐、硝酸盐、硫酸盐的累积平均暴露浓度每增加1μg/m^(3),AIDS的发生风险分别增加8.6%、49.0%、20.4%、11.2%、14.5%。≥60岁,BMI≥24 kg/m2,教育程度为高中、大学及以上,曾经吸烟的感染者更容易受到大气PM_(2.5)及其组分暴露的影响。结论大气PM_(2.5)暴露增加男性HIV感染者进展为AIDS的风险,硫酸盐和黑碳是PM_(2.5)发挥毒性作用的关键组分。相关部门应高度关注高危人群,帮助改善并维持其免疫功能处于最佳水平,以期减缓HIV感染者的疾病进展。
Objective To investigate the impact of atmospheric fine particulate matter(PM_(2.5))and its components on the progression of disease progression in human immunodeficiency virus(HIV)-infected males.Methods The study employed Fine-Gray competing risk survival analysis to assess the impact of PM_(2.5)and its components on the progression of acquired immunodeficiency syndrome(AIDS)in newly diagnosed HIV-infected males in Wuhan from 2000 to 2021.The quantile G-computation models and interaction models were used to identify key toxic components of PM_(2.5)and vulnerable individuals.Results A total of 5571 newly diagnosed HIV-infected males were included in the study,with 1151 progressing to AIDS during the follow-up period,corresponding to an incidence rate of 69.10/1000 person-years.The fine-Gray competing risk survival analysis revealed that each 10μg/m^(3)increase in cumulative average PM_(2.5),the risk of progressing to AIDS increased by 28.8%(95%CI:25.5%-32.2%).Among the PM_(2.5)components,each 1μg/m^(3)increase in cumulative average exposure to organic matter,black carbon,ammonium,nitrate,and sulfate was associated with increased risk of progressing to AIDS of 8.6%,49.0%,20.4%,11.2%,and 14.5%,respectively.Individuals aged 60 and above,with a BMI≥24 kg/m2,higher education levels,or a history of smoking are more vulnerable to the effects of atmospheric PM_(2.5)and its components.Conclusions Exposure to atmospheric PM_(2.5)can increase the risk of AIDS progression in HIV-infected males.SO42-and BC are key components of PM_(2.5)that exerts the toxic effects.It is important for AIDS prevention and control departments to prioritize the high-risk individuals,and focus on improving and maintaining their immune function at optimal level in order to decelerate the disease progression of AIDS.
作者
张澜婷
刘菲菲
梁伟
淦思雨
王夏
向浩
ZHANG Lanting;LIU Feifei;LIANG Wei;GAN Siyu;WANG Xia;XIANG Hao(Department of Global Health,School of Public Health,Wuhan University,Wuhan 430071,China;Global Health Institute School of Public Health,Wuhan University,Wuhan 430071,China;Department of Epidemiology and Health Statistics,School of Public Health,Yangzhou University,Yangzhou 225000,China;Wuhan Center for Disease Control and Prevention,Wuhan 430015,China)
出处
《中华疾病控制杂志》
北大核心
2025年第3期289-295,303,共8页
Chinese Journal of Disease Control & Prevention
基金
国家自然科学基金(42375181,42307540)
武汉市卫生健康委科研项目(WY22M02)
武汉市疾病预防控制中心科研项目(K23-1602-019)。
关键词
大气污染
艾滋病
疾病进展
病毒载量
前瞻性队列
Air pollution
Acquired immunodeficiency syndrome
Disease progression
Viral load
Prospective cohort
