Survival and its related factors among adolescent and adult HIV/AIDS patients in Fujian province, 1987 – 2017

  Objective  To examine the situation and associated factors of survival among human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients registered in Fujian province.

  Methods  We collected data on 12 079 HIV/AIDS patients aged≥15 years at the diagnosis and registered in Fujian province from January 1, 1987 till December 31, 2017 for a retrospective cohort study. We calculated all-cause and standardized mortality rate of the patients. Life table and Kaplan-Meier method were applied to analyze survival rate and time of the patients. Cox proportional hazard model was used to explore factors related to the survival time.

  Results  Among the patients, the all-cause and standardized mortality rate were 5.37 (95% confidence interval 95% CI: 5.10 – 5.64) and 7.99 (95% CI: 7.40 – 8.58) per 100 person-years; the average survival time was 17 (95% CI: 16.1 – 17.9) years; and the survival rate at 1, 5, 10, and 15 years were 92%, 82%, 73%, and 68%, respectively. The results of Cox proportional hazard analysis indicated that the patients being married or having a permanent heterosexual partner, being divorced or widowed, and with unknown marital status were at 1.248, 1.481, and 1.914 times higher probability of death compared to the unmarried patients; the patients aged ≥ 50 years at the diagnosis had a 2.466 times higher probability of death than the patients aged 15 – 49 years at the diagnosis; while, in comparison with the patients with the education of junior high school and below, the initial CD₄⁺ T lymphocyte cell count of < 200 cells/mm³ at the diagnosis, and not receiving highly active anti-retroviral therapy (HAART), the patients with the education of senior high school and above, the initial CD₄⁺ T lymphocyte cell count of ≥ 200 cells/mm³, and having received HAART had significantly decreased probability of death, with the hazard risk of 0.501, 0.357, and 0.146 respectively.

  Conclusion  The all-cause mortality of HIV/AIDS patients in Fujian province decreased in recent years; the patients being unmarried, aged 15 – 49 years, with the education of senior high school and above, with the initial CD₄⁺ T lymphocyte cell count of≥200 cells/mm³ at the diagnosis, and receiving HAART were at relatively lower probability of death.