The objective of this study was to determine the rate of
acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify
specific factors associated with progression of this disease.
This study utilized a retrospective cohort to identify the
specific factors involved in the progression of human immunodeficiency virus
(HIV) to AIDS. We collected data of patients existing in care between 2008 and
2012 from the national surveillance system databases. We performed our analyses
using a multivariate Cox proportional hazards model.
This study included 9216 HIV-positive patients (75.6 %
male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS
progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 %
(2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant
reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ 2 = 4341.9, P < 0.001).
The cumulative AIDS progression incidence rates were 33.4, 35.4, 36.4, 37.0 and
37.04 per 100 py in 1 each of the 5 years of follow-up. This study found
that age was an independent risk factor for the progression of HIV to AIDS.
Compared with patients infected with HIV by homosexual transmission, patients
infected with HIV by heterosexuals transmission or blood transfusion had a
reduced hazard ratio (HR) for progression
to AIDS (heterosexual transmission: HR = 0.695, 0.524, P = 0.007;
blood transfusion: HR = 0.524, P = 0.015). Diagnosed with HIV from 2011 to
2012 and having a higher CD4+ cell count (350–500 cells/mm 3 ;
or >500 cells/mm 3 ) at baseline were independently associated
with lower rates of HIV progression to AIDS [HR = 0.382, 0.380,
0.187, P < 0.001]. Patients with a CD+ T-cell
count of 200–350 cells/mm 3 or greater than 350 cells/mm 3 were
less likely to develop AIDS following HIV diagnosis than were those patients
without HAART treatment.
This study found a high progression rate from HIV to AIDS in
HIV patients residing within Zhejiang province from 2008 to 2010. This rate
decreased after 2010, which coincided with the new criteria for HAART
treatment, which likely contributed to the observed reduction in the rate of
progression. Initiation of HAART with higher CD4+ T-cell count may reduce rate
of AIDS progression. Based on our results, we conclude that efficient
strategies for HIV screening, as well as early diagnosis and treatment are
necessary to reduce the progression of HIV to AIDS.
Below: AIDS progression rates by baseline CD4+ cell count among 2008–2012: this figure demonstrated the progression of HIV to AIDS among patients with different CD4+ T-cell count
Below: AIDS progression rates by mode of transmission among 2008–2012: this figure demonstrated the progression of HIV to AIDS among patients with different transmission routes
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By: Lin
Chen1*, Jiezhe
Yang1, Renjie
Zhang1, Yun
Xu1, Jinlei
Zheng1, Jianmin
Jiang1, Jun
Jiang1, Lin
He1, Ning
Wang2, Philip
Chun Yeung3 and Xiaohong
Pan4
1 Zhejiang Provincial Center for Diseases Control and Prevention,
Hangzhou, China
2 National Center for AIDS/STD Control and Prevention, China CDC,
Beijing, China
3 Department of Surgery, Faculty of Medicine, The Chinese University
of Hong Kong, Shatin, Hong Kong
4 Department of HIV/AIDS Prevention and Control, Zhejiang Provincial
Center for Diseases Control and Prevention, 3399 Binsheng Road, Hangzhou,
Zhejiang, People’s Republic of China
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