Survival analysis on AIDS patients undergoing antiretroviral treatment, Liangshan prefecture, Sichuan province / 中华流行病学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) in Liangshan prefecture during 2004-2012.</p><p><b>METHODS</b>A retrospective cohort study was conducted to analyze the information of AIDS patients who initially received ART. Data on patients was collected from the Chinese AIDS Antiretroviral Therapy DATAFax Information System. Life table was applied to calculate the survival proportion, and Cox proportion hazard regression model was used to identify impact factors that were related to the time of survival.</p><p><b>RESULTS</b>Among 5 525 AIDS patients who initially received ART, the median age was (34.5± 9.0) year old, with 73.9% being males, 65.8% were infected through injecting drug use, time from HIV tested HIV positive to starting ART was (23.0±20.1) months. 287 cases died of AIDS related diseases, and their median time of receiving ART was (12.7±10.6) months, and 32.8% of them died within the first 6 months of treatment. Cumulative survival rates of the patients who had received ART in 1, 2, 3, 4, 5 years were 97%, 93%, 89%, 88%, 84%, respectively. Results from multivariate Cox regression showed that female patients who received ART were at a lower risk to the death of AIDS related diseases(HR = 0.556, 95%CI0.367-0.872), when compared to the males. Patients infected with HIV through injecting drug use were at a higher risk to death (HR = 1.569, 95% CI1.061-2.321) when compared to those who were infected through heterosexual transmission. Patients with baseline CD4(+) T cells counts at <50 cells/mm(3) (HR = 11.996, 95% CI 6.714-21.435) or 50-200 cells/mm(3) (HR = 2.481, 95%CI1.620-3.798) were at a higher risk to death than those with CD4(+)T cell counts ≥350 cells/mm(3). Patients without pulmonary tuberculosis were at a lower risk to death(HR = 0.511, 95% CI0.330-0.791)when compared to those with pulmonary tuberculosis a year before starting the treatment.</p><p><b>CONCLUSION</b>Antiretroviral treatment could prolong the survival time of AIDS patients and with a better rate on survival. Programs on follow-up and CD4(+)T cell counts for AIDS patients should be conducted regularly, as well as timely initiated the antiretroviral therapy.</p>