HIV cause-specific deaths, mortality, risk factors, and the combined influence of HAART and late diagnosis in Zhejiang, China, 2006\u20132013

Jiezhe Yang,Lin He,Jun Jiang,Hui Wang,Xin Zhou,Qiaoqin Ma,Yun Xu,Jianmin Jiang,Xiaohong Pan,Tingting Jiang,Jinlei Zheng,Lin Chen

doi:10.1038/srep42366

Jiezhe Yang, Lin He + Show 10 more

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https://doi.org/10.1038/srep42366

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Abstract

To examine patterns of human immunodeficiency virus (HIV) cause-specific deaths, risk factors, and the effect of interactions on mortality, we conducted a retrospective cohort study in Zhejiang, China, from 2006 to 2013. All data were downloaded from the acquired immune deficiency syndrome (AIDS) Prevention and Control Information System. The Cox proportional hazards model was used to assess predictors of cause-specific death. The relative excess risk due to interaction and ratio of hazard ratios (RHR) were calculated for correlations between HAART, late diagnosis, and age. A total of 13,812 HIV/AIDS patients were enrolled with 31,553 person-years (PY) of follow-up. The leading causes of death of HIV patients were accidental death and suicide (21.5%), and the leading cause of death for those with AIDS was AIDS-defining disease (76.4%). Both additive and multiplicative scale correlations were found between receiving HAART and late diagnosis, with RERI of 5.624 (95% CI: 1.766–9.482) and RHR of 2.024 (95% CI: 1.167–2.882). The effects of HAART on AIDS-related mortalities were affected by late diagnosis. Early detection of HIV infection and increased uptake of HAART are important for greater benefits in terms of lives saved.

Highlights

To examine patterns of human immunodeficiency virus (HIV) cause-specific deaths, risk factors, and the effect of interactions on mortality, we conducted a retrospective cohort study in Zhejiang, China, from 2006 to 2013
It has been estimated that by the end of 2011, there was a cumulative total of 78,000 people living with HIV (PLWH) in China, with 14,293 in Zhejiang province alone[1]
We evaluated whether there is an interaction between highly active anti-retroviral therapy (HAART) treatment and late diagnosis on the risk of acquired immune deficiency syndrome (AIDS)-related mortality

Summary

Introduction

To examine patterns of human immunodeficiency virus (HIV) cause-specific deaths, risk factors, and the effect of interactions on mortality, we conducted a retrospective cohort study in Zhejiang, China, from 2006 to 2013. The leading causes of death of HIV patients were accidental death and suicide (21.5%), and the leading cause of death for those with AIDS was AIDS-defining disease (76.4%) Both additive and multiplicative scale correlations were found between receiving HAART and late diagnosis, with RERI of 5.624 (95% CI: 1.766–9.482) and RHR of 2.024 (95% CI: 1.167–2.882). Previous studies have documented factors that influence mortality among HIV-infected people including HAART treatment, late diagnosis, poverty, and little or no education[9,10]. The independent roles of HAART treatment and late diagnosis have been reported[11,12], the interaction between them has not been addressed

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