Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City / 上海预防医学

ABSTRACT

Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus （HIV） infected patients receiving antiretroviral therapy （ART） in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier （K-M） method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1， 3， 5， and 8 years of ART were 96.9%， 94.9%， 93.1% and 92.1%， respectively， and the cumulative treatment response rate were 91.3%， 85.3%， 81.8% and 73.8%， respectively. Compared with aged 18-30 years old， baseline CD4+T cell >350 count/μL， normal hemoglobin level， effective ART， no clinical symptom at baseline， and homosexual transmission， we found that aged 51-60 years old（HR=4.94，95%CI：1.66-14.69）， aged over 60 years old（HR=9.14，95%CI：3.14-26.63）， anemia at baseline（HR=2.24，95%CI：1.55-3.23）， baseline CD4+T cell <200 count/μL（HR=4.35，95%CI：2.14-8.86）， ART failure （HR=3.90，95%CI：2.73-5.58）， heterosexual transmission（HR=1.92，95%CI：1.15-3.20）， and signs of symptom at baseline（HR=1.68，95%CI：1.16-2.41） were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.