Abstract:

Objetctive

To investigate the epidemiological characteristics of patients with human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS), and survival conditions and influening factors after highly active antiretroviral therapy (HAART).

Methods

The epidemiological characteristics of patients with HIV/AIDS from January 1st, 2005 to December 31st, 2021 were described by retrospective cohort approach, and the survival rates and risk factors affecting survival rates were analyzed by life table method and Cox proportional hazards model, respectively.

Results

Total of 1 085 cases were enrolled, predominately male (83.1%), with the median age of 41 (29, 53) years old, mainly by sexually transmitted infections [811 cases (74.7%)]. Total of 1 012 patients (93.2%) received free firstline HAART. There were 15 patients with abnormal serum creatinine levels during follow up after HAART,and 9 of them with hypertension, diabetes mellitus and chronic kidney disease. The cumulative survival rates of all cases at 1, 3, 5 and 10 years were 91%, 88%, 88% and 82%, respectively. Multivariate Cox regression analysis showed that the risk of death in patients aged ≥ 50 years old was 2.213 times of that in patients aged ＜30 years old (95%CI: 1.188-4.124, P ＜ 0.001). The risk of death of patients with CD4⁺ T lymphocyte ≥ 350 cells/μl was 0.325 times of that with CD4⁺ T ＜ 100 cells/μl (95%CI: 0.147-0.721, P = 0.006), patients with CD4⁺ T 200-349 cells/μl was 0.456 times of that with CD4⁺ T ＜ 100 cells/μl (95%CI: 0.245-0.850, P = 0.013), patients with CD4⁺ T 100-199 cells/μl was 0.535 times of that with CD4⁺ T ＜ 100 cells/μl (95%CI: 0.292-0.978, P =0.042). The mortality risk for patients in WHO clinical stage Ⅳ at the initiation of HAART was 3.875 times of patients in WHO clinical stage Ⅰ (95%CI: 1.537-9.771, P = 0.004).

Conclusions

Sexual transmission is the major route of HIV infection in Shantou, Guangdong Province. Patients aged 50 years old and above, low CD4⁺ T cell counts and WHO clinical stage Ⅳ are main risk factors affecting survival rate of patients with HIV/AIDS. Early detection and early treatment are the keys to improve the survival rate of patients with HIV/AIDS in this region.

Key words: Acquired immunodeficiency syndrome, Highly active antiretroviral therapy, Survival analysis, Risk factor