Multi-state Markov model analysis of disease outcomes and influencing factors in HIV infected individuals receiving antiretroviral therapy in Luzhou of Sichuan province, 2010-2021.
10.3760/cma.j.cn112338-20220401-00251
- VernacularTitle:多状态马尔科夫模型分析四川省泸州市2010-2021年抗病毒治疗HIV感染者的疾病转归及其影响因素
- Author:
Dan Dan NIU
1
;
Hou Lin TANG
1
;
Fang Fang CHEN
1
;
Ti Cheng XIAO
2
;
Chen CHEN
2
;
Hong LIU
2
;
Po LYU
1
Author Information
1. Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
2. Luzhou Prefectural Center for Disease Control and Prevention, Luzhou 646000, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
CD4 Lymphocyte Count;
China/epidemiology*;
Disease Progression;
HIV Infections/drug therapy*;
Humans;
Middle Aged;
Retrospective Studies;
Young Adult
- From:
Chinese Journal of Epidemiology
2022;43(9):1394-1400
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To construct a multi-state Markov model and analyze the disease outcomes and its influencing factors in HIV infected individuals receiving antiretroviral therapy. Methods: A retrospective cohort analysis was conducted in HIV infected individuals receiving antiretroviral therapy in Luzhou of Sichuan province from 2010 to 2021. The disease status was divided into CD4+T lymphocytes (CD4) counts >500 cells/μl, 350-500 cells/μl, 200-349 cells/μl, ≤199 cells/μl and death indicated by S1-S5 in turn. A reversible continuous-time discrete-state multi-state Markov model was constructed for the analysis of disease progression features. Results: A total of 7 542 HIV infected individuals receiving antiretroviral therapy were included, and the median age (Q1, Q3) was 53.4 (41.2, 64.5) years old. The transition intensity of S3→S2 was higher. During follow-up, the transition probability of S4→S5 increased gradually. Influencing factors analysis of disease outcomes in HIV infected individuals receiving antiretroviral therapy showed that compared with individuals 15-24 years old, the transition intensities of S2→S1, S3→S2 and S4→S3 were lower and the transition intensity of S3→S4 was higher in individuals ≥45 years old. Compared with single individuals, the transition intensities of S3→S2 and S4→S3 were higher and the transition intensities of S3→S4 and S4→S5 were lower in married individuals. The transition intensity of S1→S2 was higher in individuals with baseline CD4 counts ≤500 cells/μl than in individuals with baseline CD4 counts >500 cells/μl. The transition intensity of S3→S4 in individuals diagnosed during 2011-2015 was lower than that in individuals diagnosed in 2010 and before. Conclusions: HIV infected individuals receiving antiretroviral therapy tended to shift to the previous disease status, suggesting that antiretroviral therapy was conducive to immune reconstitution. Older age (≥45 years old), being married, low baseline CD4 counts and being diagnosed in 2010 and before were the risk factors for disease progression.
