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 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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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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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

AIDS Research and Therapy ◽

10.1186/s12981-020-00300-4 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Yunxuan Huang ◽

Oulu Zhou ◽

Zhigang Zheng ◽

Yuexiang Xu ◽

Yi Shao ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Southwestern China ◽

Aids Patients ◽

Long Term Mortality ◽

Hiv Aids

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Cryptococcal meningitis in a tertiary hospital in Pretoria, mortality and risk factors – A retrospective cohort study

International Journal of STD & AIDS ◽

10.1177/0956462416653559 ◽

2016 ◽

Vol 28 (5) ◽

pp. 480-485 ◽

Cited By ~ 5

Author(s):

J Hiesgen ◽

C Schutte ◽

S Olorunju ◽

J Retief

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Cohort Study ◽

Antiretroviral Therapy ◽

Mortality Risk ◽

Retrospective Cohort Study ◽

Cryptococcal Meningitis ◽

Retrospective Cohort ◽

Nausea And Vomiting ◽

People Living With Hiv

Aim This retrospective cohort study analyzes the impact of possible risk factors on the survival chance of patients with cryptococcal meningitis. These factors include the patient’s socio-economic background, age, gender, presenting symptoms, comorbidities, laboratory findings and, in particular, non-adherence versus adherence to therapy. Methods Data were collected from all adult patients admitted to Kalafong Hospital with laboratory confirmed cryptococcal meningitis over a period of 24 months. We analyzed the data by the presentation of descriptive summary statistics, logistic regression was used to assess factors which showed association between outcome of measure and factor. Furthermore, multivariable logistic regression analysis using all the factors that showed significant association in the cross tabulation was applied to determine which factors had an impact on the patients’ mortality risk. Results A total of 87 patients were identified. All except one were HIV-positive, of which 55.2% were antiretroviral therapy naïve. A history of previous tuberculosis was given by 25 patients (28.7%) and 49 (56.3%) were on tuberculosis treatment at admission or started during their hospital stay. In-hospital mortality was 31%. Statistical analysis showed that antiretroviral therapy naïve patients had 9.9 (CI 95% 1.2–81.2, p < 0.0032) times greater odds of dying compared to those on antiretroviral therapy, with 17 from 48 patients (35.4%) dying compared with 1 out of 21 patients (4.8%) on treatment. Defaulters had 14.7 (CI 95% 1.6–131.6, p < 0.016) times greater odds of dying, with 9 from 18 patients dying (50%), compared to the non-defaulters. In addition, patients who presented with nausea and vomiting had a 6.3 (95% CI 1.7–23.1, p < 0.005) times greater odds of dying (18/47, 38.3%); this remained significant when adjusted for antiretroviral therapy naïve patients and defaulters. Conclusion Cryptococcal meningitis is still a common opportunistic infection in people living with HIV/AIDS resulting in hospitalization and a high mortality. Defaulting antiretroviral therapy and presentation with nausea and vomiting were associated with a significantly increased mortality risk.

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The value of general health perception in health equity research: A community-based cohort study of long-term mortality risk (Finnmark cohort study 1987–2017)

SSM - Population Health ◽

10.1016/j.ssmph.2021.100848 ◽

2021 ◽

pp. 100848

Author(s):

Knut Fylkesnes ◽

Monika Dybdahl Jakobsen ◽

Nils Oddbjørn Henriksen

Keyword(s):

Cohort Study ◽

Health Equity ◽

Mortality Risk ◽

General Health ◽

General Health Perception ◽

Community Based ◽

Equity Research ◽

Health Equity Research ◽

Long Term Mortality

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Incidence of adhesive small bowel obstruction after gastrectomy for gastric cancer and its risk factors: a long-term retrospective cohort study from a high-volume institution in China

Updates in Surgery ◽

10.1007/s13304-021-00983-y ◽

2021 ◽

Author(s):

Tao Pan ◽

Danil Galiullin ◽

Xiao-Long Chen ◽

Wei-Han Zhang ◽

Kun Yang ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Cohort Study ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

High Volume ◽

Adhesive Small Bowel Obstruction

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Determinants of loss to follow-up among HIV positive patients receiving antiretroviral therapy in a test and treat setting: A retrospective cohort study in Masaka, Uganda

PLoS ONE ◽

10.1371/journal.pone.0217606 ◽

2020 ◽

Vol 15 (4) ◽

pp. e0217606 ◽

Cited By ~ 1

Author(s):

Julius Kiwanuka ◽

Jacinta Mukulu Waila ◽

Methuselah Muhindo Kahungu ◽

Jonathan Kitonsa ◽

Noah Kiwanuka

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hiv Positive ◽

Loss To Follow Up ◽

Test And Treat

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Determinants of Survival Among HIV/AIDS Patients With The Second-Line Antiretroviral Therapy In Henan Province of China

10.21203/rs.3.rs-177303/v1 ◽

2021 ◽

Author(s):

Yantao Jin ◽

Miao Zhang ◽

Yan-min Ma ◽

Hui-jun Guo ◽

Peng-yu Li ◽

...

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Retrospective Cohort Study ◽

Highly Active Antiretroviral Therapy ◽

Retrospective Cohort ◽

Cox Regression ◽

Second Line ◽

Aids Patients ◽

Cd4 Cell Count ◽

Hiv Aids

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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