| Objective Using the baseline and follow-up data of HIV/AIDS patients receiving antiretroviral treatment(ART)for the primary time in Qinghai Province from 2005-2019,understanding the underlying prevalence characteristics of HIV/AIDS patients receiving ART for the primary time,learning the survival time and virology of HIV/AIDS patients receiving ART and explore the factors influencing survival time and virological effect,and propose measures suitable for HIV ART in Qinghai Province,to lay a scientific and theoretical foundation for improving the survival status and quality of survival of HIV/AIDS patients,and optimizing the effect of HIV ART in Qinghai Province in the future.Methods This study was a retrospective cohort study.Data were derived from the Chinese Disease Prevention and Control System regarding baseline data and follow-up data of patients with HIV/AIDS who first received antiretroviral therapy in Qinghai Province from 2005-2019,which were collated and checked using Excel 2010,then merged by SPSS20.0 software for cross-sectional matching to create a database.Statistical description of quantitative information using(mean±standard deviation)or M(P25,P75)and categorical information using frequencies and percentages.Using the life table method to estimate the cumulative survival of the study subjects and plotting survival curves and using the product limit method(Kaplan-Meier)to plot the survival function curves between different factors and using the Log-rank method to test whether the differences were statistically significant.Results 1、A total of 2118 patients with HIV/AIDS who received ART for the first time were enrolled,predominantly middle-aged males and unmarried people below junior high school.The route of infection was predominantly sexual,and heterosexual transmission was predominant.A higher proportion of patients had no AIDS-related disease in the last 3 months at the time of treatment,baseline WHO clinical stage I,baseline CD4~+T-cell count greater than or equal to 200 cells/u L,and initial treatment regimen of EFV/NVP+3TC+TDF.2、At the end of the study,201 of 2118 HIV/AIDS patients died,including 140 deaths due to AIDS-related illnesses,with a mortality rate of 1.72/100 per person-years.The cumulative survival rates at years 1,3,5,and 10 after receiving ART were 97.57%,94.64%,91.91%,and 85.73%,and the cumulative survival rate at 10 years or more was 85.73%.3、Multifactorial COX results showed that age greater than or equal to 50 years at the time of treatment(a HR=1.728),number of AIDS infections greater than or equal to 2 or more diseases in the last 3 months at the time of treatment(a HR=2.007),baseline CD4~+T lymphocyte count unknown(a HR=5.459)and other initial treatment regimens(a HR=2.280)were the risk factors for death;marital status of unmarried(a HR=0.555),education level of college and above(a HR=0.480),baseline CD4+T lymphocyte count of 200 to 349/u L(a HR=0.443)and greater than or equal to 350/u L(a HR=0.221)were protective factors for death in HIV/AIDS patients.4、Among the 2118 HIV/AIDS patients,1829 patients had at least one follow-up visit documented with a viral load test value,and 1715 of the 1829patients had suppressed viral load.The suppression rate was 93.77%,the failure rate was 6.23%(114/1829).5、Multifactorial logistic results showed that the risk of virological treatment failure was higher at baseline WHO clinical stage II(a OR=4.120),a treatment regimen of EFV/NVP+3TC+AZT(a OR=2.010),EFV/NVP+3TC+d4T(a OR=2.460);age greater than or equal to 50 years(a OR=0.265)Lower risk of virological treatment failure.Conclusions Qinghai Province has a remarkable effect on HIV ART,with high survival and virological suppression rates in HIV/AIDS patients.Patients diagnosed with HIV/AIDS should be encouraged to receive ART on time,and their status should be monitored,especially during the first year of ART.Patients should be urged to test their baseline CD4~+T lymphocyte values and regularly monitor their CD4~+T lymphocyte values after ART to develop better treatment plans and evaluate the effectiveness of antiviral therapy. |
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