ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1614619
This article is part of the Research TopicTowards Control of the HIV epidemic: Trends in Epidemiology and Emerging Drug Resistance in the Integrase Inhibitor EraView all 8 articles
Survival analysis and factors influencing survival time of adult HIV/AIDS patients receiving antiretroviral therapy from 2012 to 2022 in Chongqing, China: a retrospective cohort study
Provisionally accepted
- 1Department of Non-communicable Chronic Disease Control and Prevention, Disease Control and Prevention Center of Jiulongpo Distract, Chongqing, China, hongqing, China
- 2Department of Epidemiology, School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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BACKGROUND: Despite expanded antiretroviral therapy (ART) coverage in China, AIDS remains a major public health challenge. This study aimed to assess survival outcomes and identify factors influencing survival time among HIV/AIDS patients receiving ART. METHODS: This study was a retrospective cohort study utilizing data on HIV patients receiving antiretroviral therapy in Jiulongpo District, Chongqing, from 2012 to 2022. Life tables estimated cumulative survival, Kaplan-Meyer compared survival between groups, and accelerated time to failure (AFT) modeling was used for analysis of factors influencing survival time. RESULTS: The 1-, 3-, 5-and 10-year cumulative survival rates were 94% (95% CI: 0.93 to 0.95), 90% (95% CI: 0.89 to 0.91), 86% (95% CI: 0.85 to 0.87), and 79% (95% CI: 0.76 to 0.81), respectively. Compared to patients aged 15-29, those aged 30-49 (TR=0.22, 95% CI: 0.11 to 0.46, P<0.01) and ≥50 (TR=0.07, 95% CI: 0.03 to 0.15, P <0.01) had shorter survival. Males (TR=0.26, 95% CI: 0.17 to 0.38, P <0.01), single (TR=0.52, 95% CI: 0.33 to 0.84, P =0.007), and divorced/widowed patients (TR=0.67, 95% CI: 0.48 to 0.93, P =0.018) had shorter survival compared to their counterparts. Infection via homosexual contact (TR=0.21, 95% CI: 0.12 to 0.37, P <0.01), injection drug use/other routes (TR=0.09, 95% CI: 0.04 to 0.20, P <0.01) was associated with shorter survival than heterosexual contact. Patients with tertiary (TR=5.88, 95% CI: 3.05 to 11.33, P <0.01), high school (TR=2.86, 95% CI: 1.87 to 4.36, P<0.01), and middle school education (TR=1.93, 95% CI: 1.40 to 2.67, P=0.002) had longer survival than those with primary/illiterate education. Baseline CD4 counts of ≥350 (TR=3.26, 95% CI: 2.33 to 4.55, P<0.01) and 200-349 cells/μL (TR=2.73, 95% CI: 1.90 to 3.92, P<0.01) were linked to longer survival compared to 0-199 cells/μL. CONCLUSION: Older age, males, lower educational attainment, homosexual contact, injection of drugs, and lower baseline CD4 levels are influential factors for shorter survival time in HIV/AIDS patients receiving ART. These findings may help inform clinical decision-making and targeted interventions to improve the long-term outcomes of people living with HIV.
Keywords: hiv/aids, survival analysis, prognosis, antiretroviral therapy, accelerated failure time model, Cohort Studies
Received: 19 Apr 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Huang, He, Zhang, Mu and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lihong Mu, Department of Epidemiology, School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China
Cheng Tang, Department of Non-communicable Chronic Disease Control and Prevention, Disease Control and Prevention Center of Jiulongpo Distract, Chongqing, China, hongqing, China
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