Survival of HIV/AIDS patients infected via mother to child transmission

  Objective  To examine the survival and its related factors among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients infected via mother to child transmission in Guangxi Zhuang Autonomous Region (Guangxi).

  Methods  We collected data on 940 HIV/AIDS patients from Chinese National HIV/AIDS Comprehensive Control and Prevention Information System for a retrospective cohort study. The participants of the study were permanent residents of Guangxi and registered between 2001 through 2015; HIV infection via mother to child transmission or maternal HIV positive was confirmed among all the participants. The survival curve was estimated using Kaplan-Meier method and influencing factors for the survival was analyzed with Cox proportional hazard regression.

  Results  The median observation time was 2.39 years. Totally 207 cases died during the follow-up and the mortality rate was 7.79/100 person years. The Cox proportional hazard analyses revealed that initial CD4 cell count, source of registration information, and therapeutic status were correlated with the survival of the patients; after adjusting for confounding factors, the death risk were higher among the patients with lower initial CD4 cell count (hazard risk HR = 1.72, 2.64, and 3.74 for the participants with the initial CD4 count of 500 – 351, 350 – 200, and < 200 cells/μL compared to those with the count of > 500 cells/μL), being diagnosed as HIV positive in hospitals (HR = 2.13 compared to those diagnosed in voluntary counseling and testing), and without antiviral therapy (HR = 12.62 compared to those with antiviral therapy). The survival curves for the patients with and without antiviral therapy were significantly different (χ² = 386.705, P < 0.001).

  Conclusion  Early diagnosis and treatment need to be greatly improved for HIV/AIDS patients infected via mother to child transmission in Guangxi and the survival of the patients is mainly influenced by initial CD4 cell count, source of registration information, and therapeutic status.