Effect of baseline CD(4)(+) T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015.
10.3760/cma.j.issn.0254-6450.2018.09.014
- Author:
X H LIU
1
;
Q Y ZHU
1
;
J M SU
1
;
Q MENG
1
;
X J ZHOU
1
;
Z Y SHEN
1
;
Z Z TANG
1
;
W M YANG
1
;
Y H RUAN
2
;
Y M SHAO
2
Author Information
1. Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
2. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
- Publication Type:Journal Article
- Keywords:
Antiretroviral therapy;
CD(4)(+) T cell count;
Drop-out;
HIV infected persons
- MeSH:
Adolescent;
Anti-Retroviral Agents/administration & dosage*;
CD4 Lymphocyte Count;
China/epidemiology*;
HIV;
HIV Infections/virology*;
Humans;
Incidence;
Medication Adherence;
Retrospective Studies;
T-Lymphocytes
- From:
Chinese Journal of Epidemiology
2018;39(9):1216-1221
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effect of baseline CD(4)(+) T cell count (CD(4)) on drop-out of antiretroviral therapy (ART) in HIV infected persons. Methods: Retrospective cohort was conducted in this study. HIV infected persons aged≥18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System, with follow-up conducted till May 30, 2016. Cause-specific Cox proportional hazard models were used to evaluate effect of different CD(4) on the drop-out of ART in the HIV infected persons. Results: A total of 58 502 eligible study participants were included in this retrospective cohort study. The average drop-out ratio was 4.8/100 person-years. After controlling the following baseline covariates: age, sex, marital status, route of HIV infection, WHO clinical stage before ART, initial/current ART regiment, ART regiment adjustment, and year of initiating ART for potential confounding, the adjusted HR of drop-out for HIV infected persons with 200- cells/μl, 351-cells/μl and ≥500 cells/μl were 1.110 (95%CI: 1.053-1.171, P<0.001), 1.391 (95%CI: 1.278-1.514, P<0.001) and 1.695 (95%CI: 1.497-1.918, P<0.001), respectively, in risk for drop-out compared with those with baseline CD(4)<200 cells/μl. Among the HIV infected persons, 56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication. Conclusions: With the increase of baseline CD(4) when initiating ART, the risk for the drop-out in HIV infected persons increased significantly. To further reduce the drop-out of ART, it is important to take CD(4) into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
