Sex Specific Mortality in HIV/AIDS Patients Receiving Antiretroviral Therapy & Risk Factors in Xinjiang Uygur Autonomous Region
OBJECTIVE:
To
analyze the sex specific mortality in HIV/AIDS patients receiving highly active antiretroviral therapy
(HAART) and risk factors in Xinjiang Uyghur autonomous region (Xinjiang), and
provide evidence for the evaluation of the effect of HAART.
METHODS:
A
retrospective analysis was conducted on the mortality and survival of 8 061
male cases and 6 001 female cases of HIV infection, who received HAART during
July 2004-June 2013 in Xinjiang. The information of the cases were downloaded
from national antiretroviral therapy reporting sub-system in national HIV/AIDS
reporting system. Cox proportional hazard model was used to identify the risk
factors of deaths.
RESULTS:
The male
cases were older and had lower CD4 value at baseline compared with the female
cases. The major transmission route was injecting drug use in males, but sexual
contact in females. The overall mortality of the male cases was higher than
that of the females, which was 10.87/100 person-years during the first three
month after receiving HAART, and 7.00/100 person-years two years later in males,
but 4.77/100 person-years during the first three month and 3.00/100
person-years two years later in females. The results from Cox analysis showed
that the risk factors were the CD4 value at baseline and transmission route.
Compared with the cases who had lower CD4 value (CD4<200 cells/µl) at
baseline, the HR for the cases who had higher CD4 value (CD4≥350 cells/µl) was
4.08 (95% CI: 2.96-5.62) in males and 5.11 (95% CI: 3.16-8.35) in females.
Compared with sexual transmission, the HR for IDUs was 1.99 (95% CI: 1.66-2.40)
in males and 1.77 (95% CI: 1.24-2.52) in females. The results of cumulative
survival analysis showed that in conventional treatment group (CD4<350
cells/µl) , the five year survival rates were 81% and 87% for the males and
females infected through sexual contact and 66% and 75% for the males and
females infected through injecting drug use, and in early treatment group
(CD4≥350 cells/µl) , the five year survival rates were 97% and 98% for the
males and females infected through sexual contact and 86% and 97% for the males
and females infected through injecting drug use.
CONCLUSION:
In
Xinjiang, the higher mortality in male HIV infection cases receiving HAART was
related with lower CD4 value at baseline and higher infection rate through injecting
drug use. Besides the weak intention for treatment and poor compliancy would be
the deeper risk factors.
- 1Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China; Email: xjnmj@126.com.
- 2Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China.
- Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Sep;36(9):971-5.
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