A retrospective cohort study on survival time of AIDS death cases receiving Antiretroviral Therapy and related factors / 中华预防医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To analyze survival time of AIDS death cases receiving Antiretroviral Therapy and related factors.</p><p><b>METHODS</b>A retrospective cohort study was carried out to collect the data on death cases receiving Antiretroviral Therapy by the National HIV/AIDS Comprehensive Response Information Management System. Kaplan-Meier was used to calculate the median survival time, and compare survival time among different groups of age, sex, marriage status, infectious routes, WHO clinical stage, baseline CD4(+)T cell counts, and interval time from the start of ART to HIV confirmation. Life table and survival curve were applied to describe survival distribution. Cox proportional hazard model was used to determine the factors associated with the survival time.</p><p><b>RESULTS</b>Among 142 AIDS death cases, 125 (88.03%) were related with AIDS and 17(11.97%) were not. The total median survival time was 3.100 months (95%CI 2.279-3.921). The cumulative survival rate was (52 ± 4)%, (33 ± 4)%, (26 ± 4)% in the first 3 months, 3-6 months, and 6-12 months. The median survival time of married or cohabitation group was 2.670 months (95%CI1.470-3.870), and single (unmarried, divorced, separation, widowed) group was 5.870 months (95%CI 2.617-9.123). The median survival time of WHO clinical stage I or II group was 5.870 months (95%CI 3.989-7.751), and WHO clinical stage III or IV group was 1.700 months (95%CI 0.885-2.515). The median survival time of baseline CD4(+)T cell counts ≤ 50 /µl group was 1.670 months (95%CI 0.759-2.581), and 51-199 /µl group was 4.400 months (95%CI 2.735-6.065), and ≥ 200/µl group was 7.100 months (95%CI 0.000-14.542). The survival time was significantly different among different baseline marital status groups, different WHO clinical stage groups, and different CD4(+)T cell counts groups. The mortality risk of Single (unmarried, divorced, separation, widowed) group was 0.641 times of the risk in married or cohabitation group. The mortality risk of WHO clinical stage III or IV was 1.856 times of the risk in stage I or II. The mortality risk of baseline CD4(+)T cell counts 51-199 /µl group was 0.582 times of the risk in ≤ 50 /µl group, and ≥ 200 /µl group was 0.551 times of the risk in ≤ 50 /µl group.</p><p><b>CONCLUSION</b>The total median survival time was relatively short. Most AIDS deaths happened in the first 3 months or 3-6 months after they received Antiretroviral Therapy, and the mortality trend slowed down in the following months. Married or cohabitation, low-baseline CD4(+)T cell counts, or WHO clinical stage III or IV were found to be the risk factors associated with AIDS death cases receiving Antiretroviral Therapy.</p>