OBJECTIVETo understand the incidence of drop out of antiretroviral therapy (ART) in people living with AIDS/HIV and related factors in Nanjing, Jiangsu province, and Yuncheng, Shanxi province.

METHODSRetrospective cohort analysis was conducted. The cumulative incidence curves of drop out of ART, mortality and drug withdrawal were drawn with Kaplan-Meier method. The related factors were identified with Cox proportional hazards regression model.

RESULTSA total of 1 006 patients were included in Yuncheng, the median length of ART follow-up was 49.59 months (QR: 20.02-92.84), and 976 patients were included in Nanjing, the median length of ART follow-up was 19.93 months (QR: 11.48-34.07). The cumulative incidence of drop out of ART at 3 months, 6 months, 1 year, 2 years, 4 years, 8 years after ART was 8.19%, 9.23%, 11.08%, 13.75%, 17.74%, 27.66% in Yuncheng, and 3.01%, 5.17%, 7.47%, 10.97%, 17.45%, 28.72% in Nanjing respectively. Age, marital status, infection route, baseline CD4 cell count, the clinical stage classified by WHO at the end of the observation were correlated with the drop out of ART.

CONCLUSIONIn order to reduce the drop out of ART among people living with AIDS/HIV, it is necessary to conduct effective interventions targeting the patients with young age, the patients who divorced/widowed, the patients who were intravenous drug users, the patients with higher CD4 cell count at the beginning of ART and clinical stage III or IV at the end of the follow-up and increase the coverage of HIV test.

Acquired Immunodeficiency Syndrome ; drug therapy ; Anti-Retroviral Agents ; administration & dosage ; CD4 Lymphocyte Count ; China ; Communicable Diseases ; Humans ; Incidence ; Medication Adherence ; Proportional Hazards Models ; Retrospective Studies

Acquired Immunodeficiency Syndrome ; blood ; drug therapy ; Adult ; Anti-Retroviral Agents ; administration & dosage ; Female ; Humans ; Male ; Metalloids ; blood ; Metals ; blood ; Middle Aged ; Young Adult

Adult ; Aged ; Anti-Retroviral Agents ; administration & dosage ; China ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Time-to-Treatment ; statistics & numerical data ; Young Adult

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.
Adolescent ; Anti-Retroviral Agents/administration & dosage* ; CD4 Lymphocyte Count ; China/epidemiology* ; HIV ; HIV Infections/virology* ; Humans ; Incidence ; Medication Adherence ; Retrospective Studies ; T-Lymphocytes

Acute Kidney Injury ; blood ; etiology ; therapy ; Anti-Retroviral Agents ; administration & dosage ; CD4 Lymphocyte Count ; Disease Progression ; Embolization, Therapeutic ; methods ; Fatal Outcome ; Gastrointestinal Hemorrhage ; diagnostic imaging ; etiology ; physiopathology ; therapy ; Glucocorticoids ; administration & dosage ; HIV Infections ; complications ; diagnosis ; immunology ; HIV-1 ; drug effects ; isolation & purification ; Humans ; Male ; Middle Aged ; Purpura, Schoenlein-Henoch ; complications ; diagnosis ; physiopathology ; Radiography ; Renal Dialysis ; methods