Mortality Risk Factors Among People Living with HIV Receiving Second-line Antiretroviral Therapy in Rural China


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Abstract

Background:Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing.

Objective:This study aimed to investigate the survival and factors affecting mortality among this group.

Methods:We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan–Meier method and Cox proportional hazards models.

Results:We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55–0.79), > 50 years old (HR, 2.69; 95% CI, 2.03–3.56), single/widowed (HR, 1.26; 95% CI, 1.04–1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65–0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52–0.96), liver injury (HR, 1.58; 95% CI, 1.19–2.10), and CD4+ T cell counp <000 cells/µl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/µl (HR, 1.37; 95% CI, 1.03–1.82) were associated with mortality risk.

Conclusions:We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.

About the authors

Qiujia Kang

The First Clinical Medical School, Henan University of Chinese Medicine

Email: info@benthamscience.net

Wanqi Pan

The First Clinical Medical Schoo, Henan University of Chinese Medicin

Email: info@benthamscience.net

Yanmin Ma

Center for AIDS/STD Control and Prevention, Center for Disease Control and Prevention of Henan Province

Email: info@benthamscience.net

Dongli Wang

The First Clinical Medical School, Henan University of Chinese Medicine

Email: info@benthamscience.net

Huangchao Jia

The First Clinical Medical School, Henan University of Chinese Medicine

Email: info@benthamscience.net

Huijun Guo

Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine

Email: info@benthamscience.net

Feng Sang

Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou

Email: info@benthamscience.net

Liran Xu

Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine

Email: info@benthamscience.net

Qianlei Xu

The First Clinical Medical School, Henan University of Chinese Medicine,

Author for correspondence.
Email: info@benthamscience.net

Yantao Jin

Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, First Affiliated Hospital of Henan University of Chinese Medicine

Author for correspondence.
Email: info@benthamscience.net

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