Risk analysis of immunological failure of antiretroviral therapy in HIV/AIDS patients in Taizhou prefecture, 2006-2019
10.3760/cma.j.cn112338-20200330-00465
- VernacularTitle:台州市2006-2019年艾滋病抗病毒治疗免疫学失败风险分析
- Author:
Jiayu HE
1
;
Haijiang LIN
;
Shanling WANG
;
Guixia LI
;
Weiwei SHEN
;
Xiaoxiao CHEN
;
Na HE
Author Information
1. 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室，上海 200032
- Keywords:
HIV/AIDS;
Antiretroviral therapy;
Immunological failure;
Anemia
- From:
Chinese Journal of Epidemiology
2020;41(11):1888-1893
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the immunological failure of antiretroviral therapy (ART), its association with baseline anemia and related factors in HIV/AIDS patients in Taizhou prefecture, during 2006-2019.Methods:A retrospective cohort study was conducted among HIV/AIDS patients under ART. Cox regression model was used to analyze predictors of immunological failure and logistic regression model was used to analyze factors of baseline anemia.Results:A total of 2 904 HIV/AIDS patients were enrolled with a median time of 28 ( P 25- P 75:12-53) months follow-up of ART, in which 177 cases (6.1 %) were identified as immunological failure with a failure rate of 2.17 per 100 person-years. The cumulative incidence rates of immunological failure in the first, third, fifth, and tenth years were 5.49 %, 6.94 %, 7.30 % and 8.82 %, respectively. Results of multivariate logistic regression analysis showed that for the risk of baseline anemia, ≥66 years old group had 4.17 times higher risk than 18-25 years old group (95 %CI: 1.68-10.33), males had 0.67 times higher risk than females (95 %CI: 0.50-0.89), and CD 4+T cell counts (CD 4)<200 cells/μl group had 4.35 times higher risk than CD 4≥350 cells/μl group (95 %CI: 2.81-6.72), baseline white blood cells<4.0×10 9 cells/L group had 1.73 times higher risk than 4.0×10 9 cells/L-9.9×10 9 cells/L group (95 %CI: 1.31-2.29), baseline platelet counts <100×10 9 cells/L and >300×10 9 cells/L groups had 2.02 times and 4.45 times higher risk than 100×10 9 cells/L-299×10 9 cells/L group (95 %CI: 1.36-3.01, 95 %CI: 3.05-6.50), respectively. WHO classified stage Ⅲ/Ⅳ group had 2.15 times higher risk than WHO classified stageⅠ/Ⅱ group (95 %CI: 1.61-2.87), while heterosexual transmission group had 2.03 times higher risk than homosexual transmission group (95 %CI: 1.42-2.92). Results of multivariate cox proportional risk regression showed that for the risk of immunological failure, baseline anemia group had 1.77 times higher risk than no anemia group (95 %CI: 1.20-2.60), WHO classified stage Ⅲ/Ⅳ group had 1.66 times higher risk than WHO classified stage Ⅰ/Ⅱ group (95 %CI: 1.10-2.48), and withdrawal of follow up and death groups had 3.18 times and 4.61 times higher risks than treatment group (95 %CI: 1.96-5.19, 95 %CI: 2.98-7.13), respectively. Conclusions:The immunological effect of ART among HIV/AIDS patients in Taizhou prefecture was affected by multiple factors, including anemia, clinical stage and follow-up status. Enhancing surveillance of baseline anemia and timely correction of anemia in elder group can help improve treatment outcome of HIV/AIDS patients.
