The effect evaluation of highly active antiretroviral therapy to patients with AIDS in Hubei province of China

Li, Xuehua; Xu, Yu; Nie, Shaoping; Xiang, Hao; Wang, Chongjian

doi:10.1007/s11596-009-0510-9

Cited by 6 publications

(7 citation statements)

References 34 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that excess mortality risk exist in AIDS patients with more severe disease (lower CD4 + T-cell count at AIDS diagnosis). Consistently with previous evidence, disease severity was proved as an independent risk factor for poor survival [4], [29], [30], whereas, HAART acted as an independent preventive factor for delaying progression to AIDS and prolonging survival for its role in improving clinical symptoms of AIDS patients, reducing HIV RNA concentration, and maintaining immune function [4], [5], [6], [31].…”

Section: Discussionsupporting

confidence: 83%

Determinants of Progression to AIDS and Death Following HIV Diagnosis: A Retrospective Cohort Study in Wuhan, China

et al. 2013

Self Cite

View full text Add to dashboard Cite

ObjectiveTo identify determinants associated with disease progression and death following human immunodeficiency virus (HIV) diagnosis.MethodsDisease progression data from the diagnosis of HIV infection or acquiring immunodeficiency syndrome (AIDS) to February 29, 2012 were retrospectively collected from the national surveillance system databases and the national treatment database in Wuhan, China. Kaplan-Meier method, Logistic regression and Cox proportional hazards model were applied to identify the related factors of progression to AIDS or death following HIV diagnosis.ResultsBy the end of February 2012, 181 of 691 HIV infectors developed to AIDS, and 129 of 470 AIDS patients died among whom 289 cases received concurrent HIV/AIDS diagnosis. Compared with men infected through homosexual behavior, injection drug users possessed sharply decreased hazard ratio (HR) for progression to AIDS following HIV diagnosis [HR = 0.31, 95% confidence interval (CI), 0.18–0.54, P = 4.01×10−5]. HIV infectors at least 60 years presented 1.15-fold (HR = 2.15, 95% CI, 1.15–4.03, P = 0.017) increased risk to develop AIDS when compared with those aged 17–29 years. Similarly, AIDS patients with diagnosis ages between 50 and 59 years were at a 1.60-fold higher risk of death (HR = 2.60, 95% CI, 1.18–5.72, P = 0.017) compared to those aged 19–29 years. AIDS patients with more CD4+ T-cells within 6 months at diagnosis (cell/µL) presented lower risk of death (HR = 0.29 for 50- vs <50, 95% CI, 0.15–0.59, P = 0.001). The highly active antiretroviral therapy (HAART) delayed progression to AIDS from HIV diagnosis (HR = 0.15, 95% CI, 0.07–0.34, P = 6.46×10−6) and reduced the risk of death after AIDS diagnosis (HR = 0.02, 95% CI, 0.01–0.04, P = 7.25×10−25).ConclusionsProgression to AIDS and death following HIV diagnosis differed in age at diagnosis, transmission categories, CD4+ T-cell counts and HAART. Effective interventions should target those at higher risk for morbidity or mortality, ensuring early diagnosis and timely treatment to slow down the disease progression.

show abstract

Section: Discussionsupporting

confidence: 83%

Determinants of Progression to AIDS and Death Following HIV Diagnosis: A Retrospective Cohort Study in Wuhan, China

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…TLC might be useful for monitoring the progression of HIV/AIDS in resource-limited settings [10] . Although in China HAART has been extensively used in HIV-infected patients [11] , CD4 monitoring remains unavailable to all individuals with HIV infection/AIDS, and few studies investigated the correlation between CD4 count and TLC in a cohort of HIV-positive patients. Therefore, this study examined the correlation between TLC and CD4 count, and evaluated TLC as a measure for monitoring disease progression and curative effect of HAART in HIV-infected patients.…”

mentioning

confidence: 99%

Correlation analysis on total lymphocyte count and CD4 count in HIV-infected patients: A retrospective evaluation

Wang¹,

Shen²,

et al. 2011

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

View full text Add to dashboard Cite

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy (HAART) and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count (TLC) and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties (Shangcai, Queshan, Shenqiu and Weishi) were included in the study. Pearson correlation and receiver operating characteristic (ROC) were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART (P<0.01). An overall positive correlation was noted between TLC and CD4 count (pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001). The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm(3) could predict CD4 < 200 cells/mm(3) with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count < 200 cells/mm3 was a TLC ≤ 1300 cells/mm(3), with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change (r=0.77, P=0.0001) at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm(3). TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

show abstract

“…Furthermore, most of these patients were migrants, had lower lever of education, and older. HAART plays an important role in delaying the progression of HIV to AIDS because it can reduce the HIV–RNA concentration and restoring the immune system [ 22 – 24 ]. In recent years, increasing number of researches encouraged early treatment with CD4+ T-cell count less than 500 cells/mm 3 or more [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

View full text Add to dashboard Cite

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.

show abstract

The effect evaluation of highly active antiretroviral therapy to patients with AIDS in Hubei province of China

Cited by 6 publications

References 34 publications

Determinants of Progression to AIDS and Death Following HIV Diagnosis: A Retrospective Cohort Study in Wuhan, China

Determinants of Progression to AIDS and Death Following HIV Diagnosis: A Retrospective Cohort Study in Wuhan, China

Correlation analysis on total lymphocyte count and CD4 count in HIV-infected patients: A retrospective evaluation

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

Contact Info

Product

Resources

About