Survival and its influencing factors among HIV/AIDS patients in Nanchang city, 1994 – 2018

  Objective  To examine the survival of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and its influencing factors in Nanchang city of Jiangxi province.

  Methods  A retrospective cohort study was conducted to analyze the data of 2 996 HIV/AIDS cases registered from 1994 through May 2018 in Nanchang city. Life table method was applied to calculate survival probability. Kaplan-Meier method was used to draw survival curve. Cox proportion hazard regression model was used to identify factors related to survival time.

  Results  Among all the patients, 914 were died of AIDS or AIDS-related diseases during the period, with a average annual mortality rate of 2.4 per 100 person-times and a median survival time of 2.3 years. The cumulated survival rate for the patients receiving antiretroviral therapy at 1, 2, 5, 7, 10-year after the confirmed HIV infection of were 95.0%, 92.0%, 86.0%, 82.0%, and 74.0%, respectively. Multivariate Cox regression analysis showed that the risk factors for death in the patients were age at the diagnosis (≥ 60 years old vs. < 20 years old: hazard ratio HR = 1.27, 95% confidence interval 95% CI: 1.03 – 1.63), gender (male vs. female: HR = 1.27, 95% CI: 1.03 – 1.56), antiretroviral treatment (no ART vs. ART: HR = 10.44, 95% CI: 8.71 – 12.50), level of baseline CD₄ count (unknown vs. < 200 cell/mm 3: HR = 1.24, 95% CI: 1.02 – 1.50).

  Conclusion  Main influencing factors for survival in HIV/AIDS patients are the age at first diagnosis, gender, born in local region, CD₄ count at the first detection, antiviral treatment, and route of the infection. Early detection and treatment can improve the survival of HIV/AIDS patients.