Chinese HIV / AIDS Patients Underwent ART Loss Rate And Survival Analysis

[Objective] The China National Free Antiretroviral Treatment Program (NFATP) has been executed in China for more than a decade with significantly improved antiviral effect and survival outcome. "The 12th five-year (12-5)" plan prospectively explores the new, appropriate treatment plan for the demonstration regions and highly prevalent areas, aiming to decrease the mortality and promote universal antiretroviral treatment strategy to scale down viral load of the patients. There is no comparison of patient dropout rate and survival outcome between NFATP and the 12-5 plan by far.[Methods] This research extracts the baseline demographic data, CD4 cell counts, follow-up and death information of 15 years old or more HIV/AIDS patients in 2012-2015, based on the National AIDS comprehensive prevention and treatment information system and 12-5 plan database. The patients are categorized into three groups according to the place and program they are in: 12-5 plan patients,12-5 plan hospitals treated patients and other patients in 12-5 plan area. Also, dropout rate and survival probability is analyzed, stratified by baseline CD4 cell counts.[Results] 38500 eligible adult patients are enrolled into this research, in which 34429 patients in cohort 4 areas and 4071 patients in cohort 6 areas. In the cohort 4 areas, patients of 12-5 cohort have significantly higher 36-month retention rate (93.9%) and lower cumulative mortality (0.9%) than other patients. In the cohort 6 areas, patients of 12-5 cohort have significantly higher 36-month retention rate (87.9%) and lower cumulative mortality (4.7%) than other patients. In multivariate analysis, age, gender, baseline CD4 cell counts, transmission route and treatment site may have significant impact on retention rate and survival probability. Male, aging, baseline CD4 cell count ≤200/μL, intravenous drug user transmission and treatment outside the 12-5 plan hospitals are associated with poor retention and survival outcome.[Conclusion] In this study, patients treated in the 12-5 cohort have significantly higher retention rate and survival probability than patients treated in the same hospitals and other hospitals in the same areas. The follow-up pattern and experience can be generalized in the future. Baseline CD4 cell counts still plays an important role in long-term follow-up and survival outcome. We should insist on "Early test, early detection and early treatment" policy and improve the treatment outcome in the future.