Survival of untreated HIV／AIDS patients in Tianjin / 中华临床感染病杂志

ABSTRACT

Objective To analyze the survival and influencing factors of treatment-naive HIV／AIDS patients aged 15 years or above in Tianjin.Methods The data of 973 untreated HIV／AIDS patients aged 15 years or above who were diagnosed during June 28 1996 to May 28 2017 in Tianjin were retrospectively analyzed.The survival rate of patients was calculated by the life table method , and the factors affecting the survival time were analyzed by the Cox proportional hazard model.Results There were 726 HIV carriers (74.6%) and 247 AIDS patients (25.4%).Among them, there were more males (93.7%, 912／973) than females (6.3%, 61／973); Han nationality accounted for 92.5%(900／973); the education level of most patients was high school or below (71畅0%, 691／973); half of the patients were unmarried (50.4%, 490／973); 57.7%(561／973) of the patients were infected by men who have sex with men ( MSM);62畅9%(612／973) were local residents and 37.1%(361／973) were migrants; 36.6%(356／973) cases were detected by pre-transfusion tests, and 74.5%( 725／973) had initial CD4 +T count tests.In this series, the average survival time is 11.03 years after diagnosis (95%CI 10.01-12畅05 years).The 1, 3, 5, and 10-year survival rates after diagnosis were 96.8%, 88.7%, 80.2%and 40.5%.183 cases (18畅8%) died from AIDS.Cox proportional hazard model analysis showed that compared with patients aged 15 to 35 years, patients aged 35-50 years (HR＝3.077, 95%CI 1.868-5.070) and ＞50 years (HR＝2.626, 95%CI 1畅553-4.440) had higher risk of AIDS-related deaths; compared with high school education or below , patients with college education or above ( HR＝0.562, 95%CI 0.371-0.851) had a lower risk of AIDS death; injection drug user (IDU) (HR＝0.751, 95%CI 0.316-0.909) had lower risk of death than MSM. Patients detected by the consultation ( HR＝0.463, 95%CI 0.252-0.851), special investigation ( HR＝0畅263, 95%CI 0.116-0.593), detainee physical examination ( HR＝0.055, 95%CI 0.007-0畅441) and STD clinic visits (HR＝0.033, 95%CI 0.005-0.239) had a lower risk of death than those detected by pre-transfusion tests.The initial CD4 +T lymphocyte counts were negatively correlated with the risk of AIDS-related death (P＜0.01).Conclusions The average survival time after diagnosis of untreated HIV／AIDS patients aged 15 years or above was 11.03 years in Tianjin.The age, education level, route of infection, detection of HIV infection and the initial CD 4 +T lymphocyte counts are related to the survival time after diagnosis of untreated HIV／AIDS patients.