Efficacy and safety of early initiating antiretroviral therapy for patients with HIV/AIDS in Hengxian County of Guangxi Zhuang Autonomous Region

doi:10.3877/cma.j.issn.1674-1358.2016.04.004

Abstract

Abstract:

Objective

To evaluate the efficacy of early initiating antiretroviral therapy (ART) for patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), and to provide scientific evidence for early ART.

Methods

Patients with HIV/AIDS were enrolled and initiated ART for one year in Hengxian County, Guangxi Zhuang Autonomous Region. Patients were divided into early treatment group and delayed treatment group. The cases of death, progress to AIDS, loss to follow-up, treatment withdrawal, treatment retention, virological suppression, immunological recovery and drug adverse reaction were compared between the two groups.

Results

Among the 288 patients, 52 cases were in the early treatment group and 236 cases were in the delayed treatment group. In the early treatment group, 2 cases (3.8%) died or progressed to AIDS, 2 cases (3.8%) were lost to follow-up, 9 cases (17.3%) gave up treatment, 40 cases (76.9%) were under treatment during the whole observation period. In the delayed treatment group, 68 cases (28.8%) died or progressed to AIDS, 13 cases (5.5%) were lost to follow-up, 24 cases (10.2%) gave up treatment, 173 cases (74.0%) were under treatment during the whole observation period. The rate of death/AIDS in the early treatment group was lower than that of the delayed treatment group (χ² = 14.438, P = 0.000). There were no differences in rates of loss to follow-up (χ²= 0.238, P = 0.625), treatment withdrawal (χ²= 2.140, P = 0.143) and treatment retention (χ²= 0.290, P = 0.590) in both groups. The CD4⁺T cell count was 144.00 (13.00-228.00)/μl in the delayed treatment group and 131.00 (72.00-195.00)/μl in early treatment group, with no significant difference (Z =-0.026, P = 0.980). The rate of virological suppression was 95.0% in the early treatment group and 93.1% in the delayed treatment group (χ² = 0.198, P = 0.656). The adverse reaction rate was with no significant difference in both groups.

Conclusion

The scale-up of early initiating ART significantly reduced the Death/AIDS rate with good safety.

Key words: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), Antiretroviral therapy, Treatment effect, Early

Min Fang, Meihua Deng, Meijuan Chen, Shaoyun Zhou, Meirong Li, Feili Liang. Efficacy and safety of early initiating antiretroviral therapy for patients with HIV/AIDS in Hengxian County of Guangxi Zhuang Autonomous Region[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(04): 402-406.

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一般资料		早期治疗组（52例）	延迟治疗组（236例）	统计量	P值
性别[例（%）]				χ²= 1.020
	男	40（76.9）	165（69.9）		0.312
	女	12（23.1）	71（30.1）		0.312
年龄（±s，岁）		54.48±15.05	54.84±13.61	t = -0.170	0.865
民族[例（%）]				χ²= 0.235
	汉	44（84.6）	193（81.8）		0.628
	少数民族	8（15.4）	43（18.2）		0.628
婚姻[例（%）]
	已婚/同居	37（71.2）	166（70.3）	χ ²= 0.014	0.907
	未婚/丧偶/独居	15（28.8）	70（29.7）		0.907
感染途径[例（%）]
	性	51（98.1）	224（94.9）	χ ²= 0.988	0.32
	吸毒	1（1.9）	12（5.1）		0.32
文化程度[例（%）]
	小学以下	27（51.9）	148（62.7）	χ²= 2.080	0.149
	初中以上	25（48.1）	88（37.3）

一般资料		早期治疗组（52例）	延迟治疗组（236例）	统计量	P值
性别[例（%）]				χ²= 1.020
	男	40（76.9）	165（69.9）		0.312
	女	12（23.1）	71（30.1）		0.312
年龄（±s，岁）		54.48±15.05	54.84±13.61	t = -0.170	0.865
民族[例（%）]				χ²= 0.235
	汉	44（84.6）	193（81.8）		0.628
	少数民族	8（15.4）	43（18.2）		0.628
婚姻[例（%）]
	已婚/同居	37（71.2）	166（70.3）	χ ²= 0.014	0.907
	未婚/丧偶/独居	15（28.8）	70（29.7）		0.907
感染途径[例（%）]
	性	51（98.1）	224（94.9）	χ ²= 0.988	0.32
	吸毒	1（1.9）	12（5.1）		0.32
文化程度[例（%）]
	小学以下	27（51.9）	148（62.7）	χ²= 2.080	0.149
	初中以上	25（48.1）	88（37.3）

组别	例数	死亡或患AIDS	失访	停药	维持治疗
早期治疗组	52	2（3.8）	2（3.8）	9（17.3）	40（76.9）
延迟治疗组	236	68（28.8）	13（5.5）	24（10.2）	173（74.0）
χ²值		14.438	0.238	2.140	0.290
P值		0.000	0.625	0.143	0.590

组别	例数	死亡或患AIDS	失访	停药	维持治疗
早期治疗组	52	2（3.8）	2（3.8）	9（17.3）	40（76.9）
延迟治疗组	236	68（28.8）	13（5.5）	24（10.2）	173（74.0）
χ²值		14.438	0.238	2.140	0.290
P值		0.000	0.625	0.143	0.590

组别	例数	消化系统症状	神经系统症状	骨髓抑制	肝功能损害	肾功能损害	过敏	血糖升高
早期治疗组	52	24（46.2）	29（55.8）	9（17.3）	12（23.1）	11（21.2）	7（13.5）	0（0.0）
延迟治疗组	236	118（50.0）	103（43.6）	43（18.2）	42（17.8）	34（14.4）	41（17.4）	3（1.3）
χ²值		0.252	2.523	0.024	0.780	1.471	0.469	0.668
P值		0.616	0.112	0.877	0.377	0.225	0.493	0.414

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