Effect of AIDS-defining events at initiation of antiretroviral therapy on long-term mortality of HIV/AIDS patients in Southwestern China: a retrospective cohort study

Abstract Background: To estimate the survival and effectors of mortality among HIV/AIDS patients switch to second-line highly active antiretroviral therapy (ART) in rural China.Methods: A three years’ retrospective cohort study was conducted and HIV/AIDS patients switched to the second-line ART between January 2009 to December 2014 enrollment. The data collected from medical records and analysis using Kaplan-Meier statistics and COX regression models.Findings: A total of 2883 HIV/AIDS participants followed up for 8445 person-years, 183 (6.5%) died, 14(0.5%) lost follow-up and the mortality rate 2.17/100 person-years. After adjusting other confounding factors by multivariable COX regression, age older than 50 years (HR,3.37; 95%CI, 1.92-5.92), Traditional Chinese medicine therapy (HR,0.48; 95%CI, 0.33-0.71), CD4 cell count littler than 200 cells/μl (HR,2.97; 95%CI, 1.90-4.64), AST or ALT higher than 50 u/L (HR,1.55; 95%CI, 1.15-2.11) were each independently associated with mortality among HIV/AIDS patients switch to second-line ART.Conclusions: Our retrospective cohort study indicates that mortality among HIV/AIDS patients switch to second-line ART lower than most other studies. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results. The result of our study suggest that Chinese therapy was potential treatment for HIV/AIDS patients.

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Effect of AIDS-defining events at initiation of antiretroviral therapy on long-term mortality of HIV/AIDS patients in southwestern China: a cohort study

10.21203/rs.3.rs-19533/v1 ◽

2020 ◽

Author(s):

Yunxuan Huang ◽

Oulu Zhou ◽

Zhigang Zheng ◽

Yuexiang Xu ◽

Yi Shao ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Antiretroviral Therapy ◽

Mortality Risk ◽

Hiv Positive ◽

Aids Patients ◽

Death Risk ◽

Long Term Mortality ◽

Hiv Aids

Abstract Objective To evaluate the impact of AIDS-defining events (ADE) on long-term mortality of HIV positive individuals on antiretroviral therapy (ART), a retrospective HIV/AIDS treatment cohort study was performed in southwestern China. Methods The cohort was established based on HIV/AIDS patients on ART recruited in Guigang city, Guangxi, China, from January 2004 to December 2018. Participants were divided into ADE and non-ADE groups, and were followed-up every six months to observe treatment outcomes. Comparison of mortality between groups was performed using the log-rank test and Kaplan-Meier analysis. Cox proportional hazard regression was used to explore the risk factors of mortality. 1:1 propensity score matching (PSM) was used to balance confounding factors and adjust the mortality risk. Results Of 6,757 participants with 29,096.06 person-years of follow-up, 16.86% (1,139/6,757) belonged to ADE group while the others (83.14%) belonged to the non-ADE group. The most common cause of death by ADE was disseminated mycosis (31.65%), followed by recurrent severe bacterial pneumonia (28.48%), herpes zoster(17.72%), and extra-pulmonary tuberculosis (8.86%). The mortality of the ADE group was significantly higher than that of the non-ADE group [3.45/100 person-years (95% CI: 2.92-3.97) vs. 2.34/100 person-years (95%CI: 2.15-2.52), P<0.001]. The death risk of the ADE group was also higher than that of the non- ADE group [adjusted hazard ratio (aHR) =1.291, 95% CI: 1.061-1.571, P =0.011], which was confirmed by PSM analysis (aHR=1.581, 95% CI: 1.192-2.099, P =0.002). Cox analysis indicated that ADE, older age, male gender, previous non-use of cotrimoxazole, advanced WHO clinical stage, and low baseline CD4+ cell count were the risk factors for death. Conclusions Even on ART, the mortality risk of HIV positive individuals with ADE was higher than those without ADE. Active testing, earlier diagnosis, and timely therapy with ART may reduce the death risk of ADE.

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Effects of cotrimoxazole prophylaxis on Talaromyces marneffei infection in HIV/AIDS patients receiving antiretroviral therapy: a retrospective cohort study

Emerging Microbes & Infections ◽

10.1080/22221751.2019.1588078 ◽

2019 ◽

Vol 8 (1) ◽

pp. 367-376

Author(s):

Junjun Jiang ◽

Fengxiang Qin ◽

Sirun Meng ◽

Eric J. Nehl ◽

Jinping Huang ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Aids Patients ◽

Talaromyces Marneffei ◽

Cotrimoxazole Prophylaxis ◽

Hiv Aids

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Modeling Outcomes of First-Line Antiretroviral Therapy and Rate of CD4 Counts Change among a Cohort of HIV/AIDS Patients in Ethiopia: A Retrospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0168323 ◽

2016 ◽

Vol 11 (12) ◽

pp. e0168323 ◽

Cited By ~ 4

Author(s):

Tadesse Awoke ◽

Alemayehu Worku ◽

Yigzaw Kebede ◽

Adetayo Kasim ◽

Belay Birlie ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

First Line ◽

Aids Patients ◽

Cd4 Counts ◽

Hiv Aids

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Individual and Joint Effects of Antiretroviral Therapy (ART) with CD4 Counts on HIV-Related Mortality of Late Diagnosis HIV/AIDS Patients: A Retrospective Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3280663 ◽

2018 ◽

Author(s):

Dayong Wang ◽

Xiang-Qing Hou ◽

Yuan Lan ◽

Jingjing Zuo ◽

Yaping Wei ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Late Diagnosis ◽

Aids Patients ◽

Cd4 Counts ◽

Joint Effects ◽

Related Mortality ◽

Hiv Aids

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Effect of AIDS-defining events at initiation of antiretroviral therapy on long-term mortality of HIV/AIDS patients in Southwestern China: a retrospective cohort study

10.21203/rs.3.rs-19533/v2 ◽

2020 ◽

Author(s):

Yunxuan Huang ◽

Oulu Zhou ◽

Zhigang Zheng ◽

Yuexiang Xu ◽

Yi Shao ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Antiretroviral Therapy ◽

Mortality Risk ◽

Retrospective Cohort ◽

Hiv Positive ◽

Death Risk ◽

Long Term Mortality ◽

Hiv Aids

Abstract Objective: To evaluate the impact of AIDS-defining events (ADE) on long-term mortality of HIV positive individuals on antiretroviral therapy (ART), a retrospective HIV/AIDS treatment cohort study performed in Southwestern China. Methods: The retrospective cohort was conducted among 6757 HIV/AIDS patients on ART (2NRTIs+1NNRTI, 2NRTIs+1PI and Single or two drugs) recruited in Guigang city, Guangxi, China, from January 2004 to December 2018. Participants were divided into ADE and non-ADE groups, and were followed-up every six months to observe treatment outcomes. Comparison of mortality between groups was performed using the log-rank test and Kaplan-Meier analysis. Cox proportional hazard regression was used to explore the risk factors of mortality. 1:1 propensity score matching (PSM) was used to balance confounding factors and adjust the mortality risk. Results: Of 6,757 participants with 29,096.06 person-years of follow-up, 16.86% (1,139/6,757) belonged to ADE group while the others (83.14%) belonged to the non-ADE group. The most common cause of death by ADE was disseminated mycosis (31.65%), followed by recurrent severe bacterial pneumonia (28.48%), herpes zoster (17.72%), and extra-pulmonary tuberculosis (8.86%). The mortality of the ADE group was significantly higher than that of the non-ADE group [3.45/100 person-years (95% CI: 2.92-3.97) vs. 2.34/100 person-years (95%CI: 2.15-2.52), P＜0.001]. The death risk of the ADE group was also higher than that of the non- ADE group [adjusted hazard ratio (aHR) =1.291, 95% CI: 1.061-1.571, P=0.011], which was confirmed by PSM analysis (aHR=1.581, 95% CI: 1.192-2.099, P=0.002). Cox analysis indicated that ADE, older age, male gender, previous non-use of cotrimoxazole, advanced WHO clinical stage, and low baseline CD4+ cell count were the risk factors for death. Conclusions: Even on ART, the mortality risk of HIV positive individuals with ADE was higher than those without ADE. Active testing, earlier diagnosis, and timely therapy with ART may reduce the death risk of ADE.

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