Survival time and associated factors of 8 310 AIDS patients initially receiving antiretroviral treatment of Liangshan Yi Autonomous Prefecture, Sichuan province of China

Abstract

To investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province. A retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System. Cox proportion hazard regression model was used to identify impact factors related survival time. Among 8 310 ART AIDS patients who initially received ART, their mean age was (34.59 ± 9.10) years old, 65.50% (5 443 cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68 ± 21.69) months. 436 cases died of AIDS related diseases, 28.67% (125 cases) of them died within the first 6 months of treatment. The cumulative survival rate of receiving ART in 1, 2, 3, 4 5 years were 97.11%, 93.41%, 90.61%, 88.81%, 86.02%, respectively. Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR = 1.57, 95% CI: 1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR = 1.64, 95% CI: 1.20-2.24), before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR = 1.53, 95% CI: 1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases (HR = 1.80, 95% CI: 1.39-2.34). The patients with baseline CD4 (+) T lymphocytes cell counts < 50/µl (HR = 9.79, 95% CI: 6.03-15.89), 50-199/µl (HR = 3.26, 95% CI: 2.32-4.59), 200-349/µl (HR = 1.69, 95% CI: 1.22-2.34), were at a higher risk death than those with CD4 (+) T lymphocytes cell counts ≥ 350/µl. Accumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province. AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4 (+) T lymphocyte count have higher risk of death.