Immunological and virologic outcomes of people living with HIV in Guangxi, China: 2012-2017

Abstract

Background Limited data are available on clinical outcomes of people living with HIV (PLWH) in China, especially after the implementation of the 2016 national treatment guideline. The objective of the current study is to examine the treatment patterns, clinical outcomes and their associated factors among PLWH in Guangxi, China before and after this new guideline. Methods Data from three community-based projects conducted at different time points over a period of six years (2012–2017) in Guangxi were analyzed in our study. The interviewer-administered questionnaire was used for data collection. Measures of clinical outcomes were retrieved from the patients’ medical records. Descriptive analysis was employed to display treatment patterns and the time trends of clinical outcomes. Chi-square test or ANOVA was used to compare the differences in background characteristics and treatment history between different levels of clinical outcomes. Results Among the pooled sample of 4224 participants, 77.3% were receiving antiretroviral therapy (ART), the median CD4 count was 328 cells/mm 3 , and 82.5% were virally suppressed. An increasing trend in both ART coverage (from 72.1% to 91.2%) and CD4 count (from 318 cells/mm 3 to 357 cells/mm 3 ) was observed over time in the three samples, while rates of viral suppression did not show a similar trend. A number of socio-demographic characteristics (e.g., female gender, younger age, Han ethnicity, and employment) and treatment-related variables (e.g., longer durations of HIV diagnosis and ART uptake, lower prevalence of comorbidity, fewer treatment interruptions, and more knowledge on ART) were associated with improved clinical outcomes. Conclusions We observed a high rate of viral suppression and increasing trends in ART coverage and CD4 count over six years in Guangxi, China. However, suboptimal clinical outcomes continue to be a problem, particularly among some subgroups of PLWH. Future clinical management strategies should be tailored for PLWH with different sociodemographic characteristics and treatment trajectories.

Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China

“…Data used in the current study were collected from September 2016 to January 2017 as part of an HIV disclosure study among 446 PLHIV in Guangxi, China [37]. With the assistance and collaboration of Guangxi Center for Disease Prevention and Control (Guangxi CDC), we randomly selected 10 sites with the largest number of HIV/ AIDS cases from 17 cities and 75 counties in Guangxi.…”

History of the HIV Epidemic in China

“…For example, the World Health Organization (WHO) has repeatedly revised treatment guidelines for resource-limited settings, and each time, leaders of China's National Free ART Program have reviewed the evidence and expanded ART coverage to meet WHO-recommendations. Most recently, in 2016, CD4-based ART eligibility requirements were eliminated in China (5), and in the following year, almost 600,000 PLWH in China were accessing ART (6).…”

Development and external-validation of a nomogram for predicting the survival of hospitalised HIV/AIDS patients based on a large study cohort in western China

“…Currently, Guangxi has the second-highest reported cases of HIV infections in China. HIV/ AIDS patients in Guangxi more often suffer from various comorbidities and have much higher mortality than the national average level [13,14]. For example, in Guangxi, approximately 16.1% of hospitalised HIV-infected patients were coinfected with Talaromyces marneffei, which is rarely found in most other areas of China and accounts for 17.5% of all deaths among HIV-infected inpatients in Guangxi [15].…”