Study on the risk of mortality and associated factors among HIV-exposed children in Henan province, 2002-2014 / 中华流行病学杂志

Objective To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014.Methods A follow-up program was set up when infants as 1,3,6,9,12,18 month olds.Data regarding the HIV-exposed children and their mothers were collected,including service of PMTCT,antiviral therapy,incidence of infectious disease and survival status of infants.Univariate and multivariate logistic regression models were used to explore the risk factors.Results A total number of 1 705 HIV-infected infants were reported from 2002 to 2014.Among them,1 536 infants (90.09％) were still alive when they were at one and a half years old,with another 58 (3.40％) lost to follow up and 111 (6.51％) infants were dead.The cumulative mortality rates in HIV-exposed children,newborn,and HIV-exposed infants were 67.39‰,23.07‰,and 57.01‰,respectively.No statistical significance was found on the decreasing tendency of mortality in different years.The leading cause of death was noticed as pneumonia,with a proportion of 32.43％,followed by suspected AIDS.Early diagnosis had not been made in infants.Low-birth weight (OR=4.97,95％CI:3.12-7.92) seemed to be a risk factor.Early detection in pregnancy (OR=0.46,95％ CI:0.26-0.80) and HARRT provided to children (OR=0.25,95％ CI:0.15-0.42) were recognized as protective factors.Conclusions The mortality of HIV-exposed children were high,which called for the development of programs on early infant diagnosis and HARRT.Measures should be taken to prevent pneumonia and other infectious diseases,together with nutrition support and monitor program on growth.

Study on the risk of mortality and associated factors among HIV-exposed children in Henan province, 2002-2014 / 中华流行病学杂志

Objective To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014.Methods A follow-up program was set up when infants as 1,3,6,9,12,18 month olds.Data regarding the HIV-exposed children and their mothers were collected,including service of PMTCT,antiviral therapy,incidence of infectious disease and survival status of infants.Univariate and multivariate logistic regression models were used to explore the risk factors.Results A total number of 1 705 HIV-infected infants were reported from 2002 to 2014.Among them,1 536 infants (90.09％) were still alive when they were at one and a half years old,with another 58 (3.40％) lost to follow up and 111 (6.51％) infants were dead.The cumulative mortality rates in HIV-exposed children,newborn,and HIV-exposed infants were 67.39‰,23.07‰,and 57.01‰,respectively.No statistical significance was found on the decreasing tendency of mortality in different years.The leading cause of death was noticed as pneumonia,with a proportion of 32.43％,followed by suspected AIDS.Early diagnosis had not been made in infants.Low-birth weight (OR=4.97,95％CI:3.12-7.92) seemed to be a risk factor.Early detection in pregnancy (OR=0.46,95％ CI:0.26-0.80) and HARRT provided to children (OR=0.25,95％ CI:0.15-0.42) were recognized as protective factors.Conclusions The mortality of HIV-exposed children were high,which called for the development of programs on early infant diagnosis and HARRT.Measures should be taken to prevent pneumonia and other infectious diseases,together with nutrition support and monitor program on growth.

Survival analysis of AIDS patients of 15 years or above years old after initiation antiretroviral treatment in Henan province during 2005 to 2014 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the survival rate of AIDS patients after receiving antiretroviral therapy(ART) in Henan province and to determine factors associated with survival status.</p><p><b>METHODS</b>Database of AIDS patients receiving ART were downloaded from China Information System for Disease Preventioin and Control-AIDS, retrospective study method was conducted to analyze the information.</p><p><b>INCLUSION CRITERIA</b>initially received national free ART during January, 2005 to December, 2014; aged 15 years or above; and with relatively complete baseline information and follow-up information. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by Cox proportional hazard model.</p><p><b>RESULTS</b>Total 30 376 AIDS patients were enrolled in this study. During the follow-up period, a total of 3 927 cases died from HIV/AIDS related diseases. The mortality of all patients was 3.2/100 person year. After 1, 5, 10 years after the initiation of ART, the rates of accumulate survival rate were 93.7%, 85.3%, and 78.4%, respectively. Stepwise regression was used to conduct the time multiple factors analysis, the results showed that man (HR=1.28, 95%CI: 1.20-1.37), older age (HR=1.20, 95% CI: 1.16-1.24), others marital status except marrage or cohabitation (HR=1.20,95% CI: 1.12-1.29), more number of symptoms (HR=1.11, 95%CI: 1.07-1.14), initial treatment were main stavudine (D4T) or zidovudine (AZT)+ didanosine(DDI)+ nevirapine (NVP) or efevirenz (EFV) (HR=1.12, 95% CI: 1.04-1.20), missing drug in the past 7 days (HR=18.36,95%CI: 17.08-19.74) among AIDS patients had high mortality risk, homosexuality sexual transmission (HR=0.59, 95% CI: 0.40-0.87), higher baseline count of CD4(+)T lymphocyte (relative to 0-200 cells/µl group, HR (95%CI) were 0.57 (0.53-0.62), 0.43(0.37-0.49), 0.33 (0.27-0.40) in 201-350 cells/µl group, 351-500 cells/µl group, and ≥501 cells/µl group, respectively), higher educations (HR=0.89, 95% CI: 0.83-0.95) had low mortality risk.</p><p><b>CONCLUSION</b>Survival rate was higher after initial antiretroviral treatment among AIDS patients in Henan province. AIDS patient will have shorter survival time after antiviral treatment under one or more following conditions: higher age, male, initial treatment with D4T or AZT + DDI + NVP or EFV, lower baseline CD4 (+) T lymphocyte count, ever missed antiviral drugs in past 7 days of latest follow-up.</p>

HIV infection status among men who have sex with men in Henan, 2008-2013 / 中华流行病学杂志

Objective To understand the infection status of HIV among men who have sex with men (MSM) in Henan province and provide scientific evidence for the development of AIDS prevention and control measures.Methods The analysis was conducted on the data about incidence of HIV infection and related risk factors among MSM in Henan from 2008 to 2013,which were obtained from AIDS reporting information system and AIDS survey in MSM.Results The constituent of HIV infection in MSM increased from 1.3％ in 2008 to 17.1％ in 2013.The HIV infection rate in MSM increased from 4.69％ in 2008 to 8.33％ in 2013 (trend x2=39.24,P＜0.001).Univariate analysis indicated that the risk factors related with HIV infection included age (x2=21.03,P＜0.001),education level (x2=31.66,P＜0.001),occupation (x2=14.59,P=0.01),condom use in the last anal sex (x2=134.97,P＜ 0.001),condom use in anal sex during past 6 months (x2 =97.15,P＜0.001),STI history (x2=67.21,P＜0.001) and syphilis prevalence (x2=163.60,P＜0.001).Multivariate analysis indicated that HIV infection related risk factors included age,STD history,syphilis prevalence and poor awareness of AIDS related knowledge.Conclusion The incidence of HIV infection among MSM in Henan increased rapidly,and homosexual transmission has become the major route of HIV infection.HIV infection related risk behavior is prevalent among MSM,therefore,it is necessary to take effective measures to prevent and control HIV/AIDS in MSM.