Survival analysis on HIV-infected children aged 14 years old and younger in China

Abstract

Objective: To understand the survival status and related influencing factors of HIV-infected children aged ≤14 years old, in China. Methods: HIV-infected children were selected from the China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). A retrospective cohort study was conducted to investigate the situation of survival on infected children. Cox proportional hazard regression model was used to screen the factors affecting the survival time. Results: This study involved 8 029 cases of infected children, with a median survival time of 179.75 months. The cumulative survival probabilities at 1 year, 2 years, 5 years, and 10 years after the diagnosis, were 99.13%, 97.95%, 90.11% and 78.63%, respectively. Results from the multivariate Cox proportional hazard regression analysis showed that children who did not receive antiviral therapy were 12.81 times more likely to die than the ones who received the antiretroviral therapy (95%CI: 11.40-14.27). Male HIV-infected children were 1.20 (95%CI: 1.10-1.32) times more likely to die than the female HIV-infected children. The risk of death among HIV positive children at the age of 3 to 5 years was 0.67 (95%CI: 0.60-0.76) times of those children who were diagnosed at the age of 2 years old or younger. The risk of death among children infected with HIV in Northwest was 0.52 (95%CI: 0.29-0.95) times higher than the ones from the Northeast areas of China. The risk of death among children who received antiviral treatment (ART) in the residential areas was 1.96 (95%CI: 1.48-2.61) times than those children who did not. The risk of death from children who did not receive health care services was 2.07 times of those children who did (95%CI: 1.88-2.29). Conclusions: The median survival time of HIV-infected children aged ≤14 years old was 179.75 months, in China. Our findings revealed that initiation of antiviral therapy, female, age, place of receiving ART (out of the residential areas), living in Northwest China, care services and being diagnosed at older age etc. were protective factors influencing the survival time of infected children.