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Mortality-trend observation in HIV/AIDS patients under antiretroviral therapy at a referral hospital in Beijing, China

    Di Yang

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Kai Wei

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Jiang Xiao

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Hongxin Zhao

    *Author for correspondence:

    E-mail Address: 13911022130@163.com

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Guiju Gao

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Fang Wang

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Liang Wu

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    ,
    Hongyuan Liang

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    &
    Liang Ni

    The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

    Published Online:https://doi.org/10.2217/fvl-2016-0064

    Aim: To study the mortality trends of HIV-1-infected patients from 2005 to 2014; to compare the mortality rate between the periods 2005 and 2010 and 2011 and 2014; and to understand the effect on mortality of initiating combination antiretroviral therapy (cART) at different baseline CD4 cell counts. Methods: This retrospective cohort study evaluated mortality among HIV-1-infected adults initiating cART during 2005–2010 and 2011–2014 at Beijing Ditan Hospital, China. Result: Data from 3057 patients were studied. During 2005–2010 and 2011–2014, median baseline CD4 cell counts were 143 and 245 cells/μl, respectively, and mortality rates were 3.7 and 2.1%, respectively. These differences were significant. Conclusion: The reduction in mortality during 2005–2010 and 2011–2014 was driven by higher baseline CD4 cell counts at cART initiation.

    Papers of special note have been highlighted as: • of interest

    References

    • 1 UNAIDS/WHO Working Group on 2012 China AIDS Response Progress Report. www.unaids.org.cn/en/index
    • 2 China Centre for Disease Control and Prevention, National Free Antiretroviral Therapy Manual, People's Medical Publishing House, Beijing, China (2004).
    • 3 Zhang F, Dou Z, Ma Y et al. Five-year outcomes of the China National Free Antiretroviral Therapy Program. Ann. Intern. Med. 151(4), 241–251 (2009). • Reported the outcome of National Free Antiretroviral Therapy Program in China.
    • 4 WHO. Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendation for a Public Health Approach. 2010 Revision. http://apps.who.int/iris/bitstream/10665/44379/1/9789241599764_eng.pdf
    • 5 Zhang F, Dou Z, Ma Y et al. Effect of earlier initiation of antiretroviral treatment and increased treatment coverage on HIV-related mortality in China: a national observational cohort study. Lancet Infect. Dis. 11(7), 516–524 (2011). • The most authoritative paper about antiretroviral therapy (ART) in China.
    • 6 China Centre for Disease Control and Prevention, National Free Antiretroviral Therapy Manual (M). People’s Medical Publishing House, Beijing, China (2011). • Initiation of ART in Chinese HIV-infected population according to Chinese guideline.
    • 7 China Records 497,000 People with HIV/AIDS. http://usa.chinadaily.com.cn/china/2014–2012/01/content_19000595.htm
    • 8 National Health and Family Planning Commission of People's Republic of China, 2014 China AIDS Response Progress Report. www.unaids.org/sites/default/files/documents/CHN_narrative_report_2014.pdf
    • 9 Deng L, Liu Z, Zhang S et al. [Survival time and related influencing factors of AIDS patients in Liangshan prefecture, Sichuan province, during 2008–2013]. Chin. J. Epidemiol. 36(6), 569–575 (2015).
    • 10 Wu Z, Zhao Y, Ge X et al. Simplified HIV testing and treatment in China: analysis of mortality rates before and after a structural intervention. PLoS Med. 12(9), e1001874 (2015).
    • 11 Rubaihayo J, Tumwesigye NM, Konde-Lule J et al. Trends and predictors of mortality among HIV positive patients in the era of highly active antiretroviral therapy in Uganda. Infect. Dis. Rep. 7(3), 5967 (2015).
    • 12 Silverman-Retana O, Bautista-Arredondo S, Serván-Mori E et al. [AIDS-related early mortality in Mexico between 2008 and 2012.] Salud Publica Mex. 57(Suppl. 2), S119–S126 (2015).
    • 13 Dragovic G, Smith C, Jevtovic D et al. HIV/AIDS mortality in a south east European country versus a west European country. J. Int. AIDS Soc. 17(4 Suppl. 3), 19620 (2014).
    • 14 Boulle A, Schomaker M, May MT et al. Mortality in patients with HIV-1 infection starting antiretroviral therapy in South Africa, Europe, or North America: a collaborative analysis of prospective studies. PLoS Med. 11(9), e1001718 (2014).
    • 15 Zhang F. Progress achievements and challenges: a review of China's free antiretroviral therapy program. J. Acquir. Immune Defic. Syndr. 65(Suppl. 2), 49 (2014).
    • 16 Zhang F, Dou Z, Yu L et al. The effect of highly active antiretroviral therapy on mortality among HIV-infected former plasma donors in China. Clin. Infect. Dis. 47(6), 825–833 (2008). • Reported effect of community-based HIV treatment model in China.
    • 17 Xiao J, Han N, Yang D, Zhao HX. Lower mortality in persons infected with HIV receiving antiretroviral treatment in a hospital-based model: an observational cohort study. Future Virol. 9(4), 363–372 (2014).
    • 18 Bender MA, Kumarasamy N, Mayer KH et al. Cost–effectiveness of tenofovir as first-line antiretroviral therapy in India. Clin. Infect. Dis. 50(3), 416–425 (2010).
    • 19 Curran A, Ribera E. From old to new nucleoside reverse transcriptase inhibitors: changes in body fat composition, metabolic parameters and mitochondrial toxicity after the switch from thymidine analogs to tenofovir or abacavir. Expert Opin. Drug Saf. 10(3), 389–406 (2011).
    • 20 Lee H, Hanes J, Johnson KA. Toxicity of nucleoside analogues used to treat AIDS and the selectivity of the mitochondrial DNA polymerase. Biochemistry 42(50), 14711–14719 (2003).
    • 21 Mulenga L, Musonda P, Mwango A et al. Effect of baseline renal function on tenofovir-containing antiretroviral therapy outcomes in Zambia. Clin. Infect. Dis. 58(10), 1473–1480 (2014).
    • 22 Wang L, Ge L, Wang L et al. Causes of death among AIDS patients after introduction of free combination antiretroviral therapy (cART) in three Chinese provinces, 2010–2011. PLoS ONE 10(10), e0139998 (2015).
    • 23 Hoffmann CJ, Schomaker M, Fox MP et al. CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multi-cohort analysis from South Africa. J. Acquir. Immune Def. Syndr. 63(1), 34–41 (2013).
    • 24 Farahani M, Price N, El-Halabi S et al. Trends and determinants of survival for over 200 000 patients on antiretroviral treatment in the Botswana National Program: 2002–2013. AIDS 30(3), 477–485 (2016). • Analysis on the risk factors of mortality in patients on ART in Botswana.
    • 25 Ford D, Robins JM, Petersen ML et al. The impact of different CD4 cell-count monitoring and switching strategies on mortality in HIV-infected African adults on antiretroviral therapy: an application of dynamic marginal structural models. Am. J. Epidemiol. 182(7), 633–643 (2015).