ABSTRACT
Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.
ABSTRACT
Objective To identify the HIV transmission in discordant couples and the epidemic characteristics of concordant couples related to HIV infection.Methods HIV/AIDS database was down-loaded from AIDS information reported system for analysis.Patients with HIV-negative couples between 2009 and 2013 in Zhejiang province were enrolled in this study.Information included demography characteristics,highly active antiretroviral therapy (HAART),HIV incidence rate and risk factors,characteristics on HIV concordant couples.Results The HIV incidence rate on HIV-negative couples of 2 575 HIV/AIDS was 3.56 per 1 000 person-year,reducing from 5.49 per 1 000 person-year in 2009 to 3.20 per 1 000 person-year in 2013.There was a slight increase on HIV incidence rate among couples in those HIV-positive men who were heterosexual,while it decreased among couples of HIV-positive women.Initiation of HAART over 1 years (OR=0.063,95％ CI:0.019-0.204) seemed to be a preventive factor for HIV transmission between the couples under study.Factors as history of infection longer than 3 years (OR=3.564,95％ CI:1.296-9.804) and beingnon-local resident (OR=2.626,95％ CI:1.098-6.230) were risky factors.Conclusion The incidence rate of HIV transmission between HIV discordant couples was low but imbalance in different areas.People who were non-local residents under HIV discordant status,would need more attention.HAART,time of infection,status of residency appeared risk factors for HIV transmission within the couples.