Rates and risk factors associated with the progression of HIV to AIDS among HIV patients from Zhejiang, China between 2008 and 2012

Abstract

ObjectivesThe objective of this study was to determine the rate of acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify specific factors associated with progression of this disease.MethodsThis study utilized a retrospective cohort to identify the specific factors involved in the progression of human immunodeficiency virus (HIV) to AIDS. We collected data of patients existing in care between 2008 and 2012 from the national surveillance system databases. We performed our analyses using a multivariate Cox proportional hazards model.ResultsThis study included 9216 HIV-positive patients (75.6 % male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 % (2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ2 = 4341.9, P < 0.001). The cumulative AIDS progression incidence rates were 33.4, 35.4, 36.4, 37.0 and 37.04 per 100 py in 1 each of the 5 years of follow-up. This study found that age was an independent risk factor for the progression of HIV to AIDS. Compared with patients infected with HIV by homosexual transmission, patients infected with HIV by heterosexuals transmission or blood transfusion had a reduced hazard ratio (HR) for progression to AIDS (heterosexual transmission: HR = 0.695, 0.524, P = 0.007; blood transfusion: HR = 0.524, P = 0.015). Diagnosed with HIV from 2011 to 2012 and having a higher CD4+ cell count (350–500 cells/mm3; or >500 cells/mm3) at baseline were independently associated with lower rates of HIV progression to AIDS [HR = 0.382, 0.380, 0.187, P < 0.001]. Patients with a CD+ T-cell count of 200–350 cells/mm3 or greater than 350 cells/mm3 were less likely to develop AIDS following HIV diagnosis than were those patients without HAART treatment.ConclusionThis study found a high progression rate from HIV to AIDS in HIV patients residing within Zhejiang province from 2008 to 2010. This rate decreased after 2010, which coincided with the new criteria for HAART treatment, which likely contributed to the observed reduction in the rate of progression. Initiation of HAART with higher CD4+ T-cell count may reduce rate of AIDS progression. Based on our results, we conclude that efficient strategies for HIV screening, as well as early diagnosis and treatment are necessary to reduce the progression of HIV to AIDS.

Impact of HIV risk factors on survival in Iranian HIV-infected patients: A Bayesian approach to retrospective cohort

“…Findings of the present study showed a strong relationship between disease stage, sexually transmitted disease (STD), CD4+ T-cell count, HBV coinfection, and AIDS with the survival time of HIV patients. In developed countries, several factors were reported including tuberculosis and HBV coinfection, intravenous drug abuse, CD4+ cell count lower than 500 cells/mm 3 , and black or brown skin as predictors for AIDS progression [19]. Based on data from the routine reporting system in Iran, up to the middle of 2009, 20,130 HIV-positive cases were detected.…”

Identifying important risk factors for survival of HIV-infected patients using censored quantile regression

“…Chen et al assessed rates and risk factors associated with the progression of HIV to AIDS among HIV-positive patients. They demonstrated that factors, including age, implementing HAART treatment, and early diagnosis and treatment can efficiently increase the time between progression of HIV to its' final and most severe stage, AIDS [18]. We found that older patients were more prone to earlier progression to AIDS.…”

The factors associated with natural disease progression from HIV to AIDS in the absence of ART, a propensity score matching analysis

“…Yang et al [17] suggested that in comparison with HIV-infected individuals infected through contaminated blood transmission, HIV-infected individuals infected through homosexual transmission had significantly lower mortality risk, while HIV-infected individuals whose transmission was through heterosexual transmission exhibited higher mortality risk. Conversely, Chen et al [18] and Yan et al [19] found that compared with those infected by blood transmission, HIV-infected individuals infected by homosexual transmission exhibited a significantly higher hazard ratio for progression to AIDS. In their opinions, the high rate of progressing to AIDS among homosexual patients may be due to less social and familial support, stigma, psychological characteristics and so on.…”

“…Conversely, Chen et al . [18] and Yan et al . [19] found that compared with those infected by blood transmission, HIV-infected individuals infected by homosexual transmission exhibited a significantly higher hazard ratio for progression to AIDS.…”