Analysis of the immunologic status of a newly diagnosed HIV positive population in China

Abstract

BackgroundThe immunologic status of a newly diagnosed HIV positive population in the era of antiretroviral therapy in China has not been extensively evaluated. We conducted a cross-sectional survey to evaluate the CD4 counts of newly diagnosed HIV-infected persons and determine the factors influencing these counts in China.MethodsTwo thousand eight hundred and sixty-six newly diagnosed HIV-infected patients from 10 provinces in China were selected during 2009 to 2010. Serum samples were collected to measure CD4 counts by flow cytometry. Demographics and medical histories were recorded. Multivariate logistic regression models were used to analyze factors associated with low CD4 count (<100 cells/mm3) at HIV diagnosis.ResultsAmong the 2866 patients, 2159 (75.33%) were male. Mean age was 40 years (range: 18–86 years). The median CD4 count at HIV diagnosis was 83 cells/mm3, 72.02% of the patients had a CD4 count that was ≤200 cells/mm3, 53.98% had CD4 counts <100 cells/mm3. The difference in CD4 counts between males and females was not statistically significant (P=0.469). The median CD4 count differed significantly according to age (P=0.002), province (P<0.001), ethnicity (P<0.001) and HIV transmission route (P<0.001). In multivariate logistic analysis, factors associated with greater odds of low CD4 count at HIV diagnosis included male sex, younger age, HIV transmission route classified as unknown transmission risk, having been diagnosed in provinces Guangxi, Henan, Heilongjiang, Jiangxi, Shanghai and Yunnan.ConclusionsAt the time of HIV diagnosis, a large proportion of HIV-infected patients in China had an initial CD4 count that was consistent with relatively advanced disease. Low CD4 count was associated with male gender, younger age, route of HIV transmission and geographical areas. HIV testing policy that promotes routine testing for HIV infection is needed to facilitate earlier HIV diagnosis.

Trends in baseline CD4 cell counts and risk factors for late antiretroviral therapy initiation among HIV-positive patients in Shanghai, a retrospective cross-sectional study

“…At the same time, despite the nationwide scale-up of HIV programs in China over the past decade, the proportion of ART-eligible HIV-positive patients who receive treatment remains low [3, 4]. What even worse is that many HIV-positive people receive late HIV diagnoses [5–7]. Both of these factors weaken the effect of ART among HIV-positive populations [8, 9].…”

The increase of sexually transmitted infections calls for simultaneous preventive intervention for more effectively containing HIV epidemics in China

“…HIV epidemics have undergone dramatic changes in China, from dominantly blood‐borne transmission in the early 1980s through the 1990s to predominantly sexually mediated transmission at the start of the 21st century . Epidemiological studies have shown that sexual transmission accounted for more than 80% of new HIV infections in 2012 and this trend of increase is expected to continue.…”

“…The number of females remains disproportionately high among the newly infected cases in the context of their proportion of the population. The HIV epidemic also exhibits distinct geographic characteristics with respect to the routes of transmission . Once almost completely eliminated, other sexually transmitted infections (STIs), such as syphilis and chlamydia, are on the rise again .…”

Clinical and Immunological Characteristics in HIV-Infected Patients at the Treatment Initiation at the University Hospital of Parakou (Benin)

“…Zannou [6] and Kra [7] had also made the same remark. Whereas Shen et al [8] reported a male predominance. In view of these results, it is hard to affirm the most predisposed sex to catch HIV infection.…”