China ; Counseling ; Female ; HIV Infections ; diagnosis ; Humans ; Pregnancy

OBJECTIVETo investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province.

METHODSA 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.

RESULTSAmong 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.

CONCLUSIONAccumulate 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.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-Retroviral Agents ; therapeutic use ; Asian Continental Ancestry Group ; China ; Female ; Humans ; Lymphocyte Count ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Substance Abuse, Intravenous ; Survival Rate ; Tuberculosis ; complications

OBJECTIVETo analyze the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) in Liangshan prefecture during 2004-2012.

METHODSA retrospective cohort study was conducted to analyze the information of AIDS patients who initially received ART. Data on patients was collected from the Chinese AIDS Antiretroviral Therapy DATAFax Information System. Life table was applied to calculate the survival proportion, and Cox proportion hazard regression model was used to identify impact factors that were related to the time of survival.

RESULTSAmong 5 525 AIDS patients who initially received ART, the median age was (34.5± 9.0) year old, with 73.9% being males, 65.8% were infected through injecting drug use, time from HIV tested HIV positive to starting ART was (23.0±20.1) months. 287 cases died of AIDS related diseases, and their median time of receiving ART was (12.7±10.6) months, and 32.8% of them died within the first 6 months of treatment. Cumulative survival rates of the patients who had received ART in 1, 2, 3, 4, 5 years were 97%, 93%, 89%, 88%, 84%, respectively. Results from multivariate Cox regression showed that female patients who received ART were at a lower risk to the death of AIDS related diseases(HR = 0.556, 95%CI:0.367-0.872), when compared to the males. Patients infected with HIV through injecting drug use were at a higher risk to death (HR = 1.569, 95% CI:1.061-2.321) when compared to those who were infected through heterosexual transmission. Patients with baseline CD4(+) T cells counts at <50 cells/mm(3) (HR = 11.996, 95% CI: 6.714-21.435) or 50-200 cells/mm(3) (HR = 2.481, 95%CI:1.620-3.798) were at a higher risk to death than those with CD4(+)T cell counts ≥350 cells/mm(3). Patients without pulmonary tuberculosis were at a lower risk to death(HR = 0.511, 95% CI:0.330-0.791)when compared to those with pulmonary tuberculosis a year before starting the treatment.

CONCLUSIONAntiretroviral treatment could prolong the survival time of AIDS patients and with a better rate on survival. Programs on follow-up and CD4(+)T cell counts for AIDS patients should be conducted regularly, as well as timely initiated the antiretroviral therapy.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-HIV Agents ; CD4 Lymphocyte Count ; Cohort Studies ; Female ; Humans ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk ; Survival Analysis ; Survival Rate ; Young Adult

OBJECTIVETo investigate the survival time and affecting factors among AIDS patients under antiretroviral treatment, between 2008 and 2013 in Liangshan, Sichuan province.

METHODSObservational retrospective cohort study method was applied. AIDS patients were chosen from China's national comprehensive prevention and control management system of AIDS in Liangshan, during 2008-2013. Related information on demographics, source of infection, pathogenesis, treatment and death was collected. Cox proportional hazards model was applied to analyze the factors that might affect the survival on patients.

RESULTSAmong the 8 321 cases, ranging from 18 to 87.5 years old (mean age as 34.2 ± 9.8), 3 021 died and 3 721 patients had received HAART treatment. The total mortality rate dropped from 43.9/100 person-years to 20.7/100 person-years from 2008 to 2013. In the treatment group, mortality rate dropped from 27.3/100 person-years to 5.1/100 person-years, while in the untreated group it remained high-between 45.0/100-50.8/100 person-years. Proportion for the treatment coverage increased gradually, from 5.8% in 2008 to 54.5% in 2013. Median survival time of all the AIDS patients was 35.1 months, but 18.4 months in the untreated group. Survival of all the AIDS patients was associated with factors as: treatment, age when AIDS diagnosis was made and route of HIV infection (P < 0.05). The risk of death among untreated patients was 5.78 times to the treated ones, but did not seem to relate to gender or nationality (P > 0.05). Survival of the treated group was associated with factors as gender, age when AIDS diagnosis was made, nationality, route of HIV infection, CD4(+) T cell count when AIDS diagnosis was made, CD4(+) T cell count at treatment baseline, anemia at the treatment baseline (P < 0.05). Survival of the untreated group was mainly associated with age when AIDS was diagnosed (P < 0.05) while other factors did not seem to be significantly related (P > 0.05).

CONCLUSIONAntiretroviral therapy appeared an important factor that affecting the survival of AIDS patients, timely treatment and CD4(+) T cell count provided at the baseline for treatment, were two key factors that affecting the outcome of treatment. Our findings pointed out that tactic factors as: strengthening the detection, monitoring on CD4(+) T cell count, early diagnose and treatment, expanding the coverage of antiretroviral therapy, and appropriate timing for treatment etc., were important ways to enhance the effects of treatment, so as to reduce the mortality rate and prolong the time of survival.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Time-to-Treatment ; Treatment Outcome ; Young Adult

OBJECTIVEIn this study, researchers investigated the demographic and clinical characteristics of AIDS patients who died in hospitals, analyzed the specific causes of death, and looked for the correlation between specific cause of death and their clinical characteristics.

METHODSData of clinical characteristics of patients and their specific causes AIDS of death who died in the seven hospitals from 2009 to 2010 were collected retrospectively. All the specific causes of death were classified according to the Cause of Death (CoDe) project protocol. Univariate analysis and multivariate logistic regression analysis were used to find the association between some categorical variables and the risk for AIDS patients died from AIDS related illnesses.

RESULTSClinical characteristics and the cause of death of the 381 deceased in seven hospitals in this study were collected. 82.4% were male, with priority as 30-45 years old. 123 (32.3%) death patients had received ART before death. In all death cases, the cause of death of 252 patients (66.1%) were due to AIDS related diseases, with opportunistic infections the most (92.4%). Tubercle bacillus, infection of Penicillium marneffei and Pneumocystis jiroveci were the three leading causes of opportunistic infection deaths. Of 129 patients who died of non-AIDS related disease, non-AIDS infection (29.5%), hepatitis (22.5%), and non-AIDS malignancy(10.1%)were the first three causes of death. The cause of death in patients who had injecting drug use behavior within one year, had not received ART or not long enough, with opportunistic infections, without hepatitis, with the last low CD4 cell counts before death etc. were tend to due to AIDS related disease.

CONCLUSIONOpportunistic infections, non-AIDS related infections and hepatitis were the three leading causes of death in this study. The duration of time on ART had impact on the patient's cause of death. The HIV infected patients who had received ART before death had more risk to die of non-AIDS related disease, compared to patients who had not. The longer time they had accessed to ART, the less likely they would die on non-AIDS related illnesses.

AIDS-Related Opportunistic Infections ; epidemiology ; mortality ; Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; mortality ; Adult ; Antiretroviral Therapy, Highly Active ; Cause of Death ; China ; epidemiology ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Retrospective Studies