AUTHOR=Zhu Zhengping , Xu Yuanyuan , Wu Sushu , Li Xin , Shi Hongjie , Dong Xiaoxiao , Xu Wenjiong 

TITLE=Survival and risk factors associated with mortality in people living with HIV from 2005 to 2018 in Nanjing, China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.989127

DOI=10.3389/fpubh.2022.989127

ISSN=2296-2565

ABSTRACT=Objectives
To evaluate survival patterns and identify factors related to death among people living with HIV in Nanjing, China.
Methods
We conducted a retrospective analysis of people living with HIV (PLHIV) registered to the national HIV/AIDS comprehensive management information system from 2005 to 2018. Life table, the Kaplan-Meier and Cox hazard proportional regression were used to calculate the survival time and its associated factors.
Results
Of the total 4235 PLHIV, 7.51% had died of AIDS-related disease (2.01/100 person years). The median survival time of PLHIV was 11.78 (95%CI：11.64~11.93) years. The cumulative proportion surviving at the end of interval was 95.17% over 1st year, 94.03% over 2nd year, 91.82% over 5th year and 85.42% over 10th year, respectively. Characteristics associated with greater risk of death included unaccepted Antiretroviral Treatment (HR=16.24, 95%CI：11.89~22.19), baseline CD4+ T lymphocyte cell count <200/μL (HR=0.40, 95%CI：0.27~0.58 for 200~349/μL; HR=0.29，95%CI：0.19~0.43 for 350~499/μL; HR=0.24, 95%CI: 0.15~0.37 for ≥500/μL), outpatient (HR=1.56, 95%CI: 1.11~2.17), inpatient (HR=1.64, 95%CI: 1.09~2.45), older age (HR =5.03, 95%CI: 2.03~12.48 for 25~49 years old; HR=9.48, 95%CI: 3.73~24.10 for ≥50 years old) and lower education background patients (HR=1.73, 95%CI: 1.10~2.74 for senior high school; HR=3.40, 95%CI: 2.26~5.11 for junior high school).
Conclusion
We found that unaccepted ART, lower basic CD4+ T lymphocyte cell count, older age and lower educated increase the risk for AIDS related death among PLHIV. Targeted intervention on test motivation and treatment initiation should be strengthened in Nanjing.