Analysis of liver-related mortality among human immunodeficiency virus infected patients after blood donation who received combined antiretroviral therapy

doi:10.3877/cma.j.issn.1674-1358.2019.05.006

Abstract

Abstract:

Objective

To investigate the effect of combined antiretroviral therapy (cART) on liver-related mortality among human immunodeficiency virus (HIV)-infected patients after blood donation.

Methods

From January 2003 to December 2015, gender, age, diagnosis point, treatment status, date of death, main causes of death and other information of 940 patients with acquired immunodeficiency syndrome (AIDS) were collected. The factors influencing the related death of liver disease of 638 patients with cART (cART treated group) and 302 untreated patients (untreated group) were analyzed, retrospectively.

Results

The overall mortality of patients in cART treated group was 33.9% (216/638), which was significantly lower than that in untreated group (93.4%, 282/302), with significant difference (χ² = 291.511, P < 0.001). However, the mortality of liver disease of patients in cART group was 7.8% (50/638), significantly higher than that in untreated group (4.0%, 12/302), with significant difference (χ² = 4.966, P = 0.026). The mortality and fatality rates of hepatitis C virus infection of patients in cART group were 7.1% (45/638) and 20.8% (45/216), which were significantly higher than those in untreated group [2.6% (8/302) and 2.8% (8/282)], with significant differences (χ² = 7.473, P = 0.006; χ² = 41.655, P < 0.001).

Conclusions

In previous HIV-infected people, cART could reduce the overall case-fatality rate, but the mortality associated with HCV infection increased.

Key words: Human immunodeficiency virus, Combination antiretroviral therapy, Mortality, Liver diseases

Rongrong Yang, Xien Gui, Yong Xiong, Shicheng Gao. Analysis of liver-related mortality among human immunodeficiency virus infected patients after blood donation who received combined antiretroviral therapy[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(05): 377-381.

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References 25

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组别	例数	男性[例（%）]	年龄（±s，岁）	HBsAg阳性[例（%）]	抗-HCV阳性[例（%）]	HCV RNA检测例数	HCV RNA阳性[例（%）]
cART治疗组	638	462（72.4）	53.8 ± 3.78	62（9.7）	555（87.0）	500	372（74.4）
未治疗组	302	218（72.2）	54.6 ± 8.20	29（9.6）	266（88.1）	240	180（75.0）
统计量	?	χ² = 0.005	t = 0.193	χ² = 0.003	χ² = 0.220	—	χ² = 0.031
P值	?	0.942	0.847	0.956	0.639	—	0.861

组别	例数	男性[例（%）]	年龄（±s，岁）	HBsAg阳性[例（%）]	抗-HCV阳性[例（%）]	HCV RNA检测例数	HCV RNA阳性[例（%）]
cART治疗组	638	462（72.4）	53.8 ± 3.78	62（9.7）	555（87.0）	500	372（74.4）
未治疗组	302	218（72.2）	54.6 ± 8.20	29（9.6）	266（88.1）	240	180（75.0）
统计量	?	χ² = 0.005	t = 0.193	χ² = 0.003	χ² = 0.220	—	χ² = 0.031
P值	?	0.942	0.847	0.956	0.639	—	0.861

组别	例数	总病死率^a	肝病相关病死率^b
组别	例数	总病死率^a	HBV感染相关^c	HCV感染相关^d
cART治疗组	638	216（33.9）	5（0.8）	45（7.1）
未治疗组	302	282（93.4）	4（1.3）	8（2.6）
χ²值	?	291.511	0.632	7.473
P值	?	< 0.001	0.427	0.006

组别	例数	总病死率^a	肝病相关病死率^b
组别	例数	总病死率^a	HBV感染相关^c	HCV感染相关^d
cART治疗组	638	216（33.9）	5（0.8）	45（7.1）
未治疗组	302	282（93.4）	4（1.3）	8（2.6）
χ²值	?	291.511	0.632	7.473
P值	?	< 0.001	0.427	0.006

组别	总例病死数	肝病相关死亡	按终末期肝病临床类型分类			按肝炎病毒分类
组别	总例病死数	肝病相关死亡	肝硬化^a	原发性肝癌^b	肝功能衰竭	HBV相关	HCV相关
cART治疗组	216	50（23.1）	34（15.7）	14（6.5）	2（0.9）	5（2.3）	45（20.8）
未治疗组	282	12（4.3）	6（2.1）	4（1.4）	2（0.7）	4（1.4）	8（2.8）
χ²值	?	40.054	30.685	9.000	0.072	0.554	41.655
P值	?	< 0.001	< 0.001	0.003	0.788	0.457	< 0.001

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