Survival analysis on AIDS antiretroviral therapy in Henan province during 2003-2009 / 中华流行病学杂志

ABSTRACT

Objective To study the effect of a government-provided-free highly activeantiretroviral treatment (HAART) program,on the reduction of mortality and relevant risk factorsamong adult (AIDS) patients in Henan province.Methods Data on the survival and deaths of AIDSpatients were collected from the National HAART reporting system between 2003 and 2009.Coxproportional hazards model was applied to analyze those factors that affecting the survival time of thepatients.Results 24 669 cases were enrolled to this study in Henan province,from 2003 to 2009.The overall mortality declined from 20.1/100 person-years in 2003 to 5.1/100 person-years in 2009.There was significant difference between the survival curves of different CD4 + T counts and differentnumbers of opportunistic infection syndromes.Results from the Multivariate Cox proportional hazardsregression analysis indicated that CD4+T cell counts ( ＞200 cells/μl,50-199 cells/μ l) was a riskfactor to death,with hazard ratio as 4.4 and 2.0 respectively.Hb of the patients that lower than 90,was a risk factor to death with the HR=1.8.Number of opportunistic infection (OIs) episodes was arisk factor to the mortality (HR=1.7).In addition,other risk factors would include age ( ≥60 years,old),being male,unmarried or divorced,ALT＞100 μl,and other routes of infection,other thanFormer Plasma Donors (FPDs),with HR as 2.2,1.6,1.5,1.3 and 1.2.However,the protectivefactors would include(1)the earlier the HAART began,the longer the survival time would last(HR =0.8 ) ; (2) when one spouse had already had the infection of HIV,it seemed helpful for the otherspouse to live longer (HR=0.8).Conclusion The National Free Treatment Program hadsignificantly reduced the AIDS mortality rate.Some effective measures should be further taken tomonitor the CD4 + T and the opportunistic infection of the AIDS patients.Patients who were in need totake the HARRT should be adopted into the ART timely,At the same time,the occurrence ofopportunistic infections should be actively prevented.