Treatment Efficacy Of Chinese Adult HIV-infected People Initiating Antiretroviral Therapy At Different Age Group

ObjectiveThe purpose of this analysis is to assess the virological and immunological outcomes of different age groups of Chinese adult HIV-infected people within 36 months after ART,to explore the other influential factors of the virological and immunological outcomes,and to put forward references for the prevention and treatment work of adult HIV/AIDS in China.MethodsWe did a retrospective observational cohort study with partial data from the China National Antiretroviral Treatment database.ART-naive adult patients whose baseline CD4/CD8 ratio<1 were included,and we divided the eligible patients into 3 baseline age groups as 18-49(reference group),50-59 and ?60 year-old.They were followed up to 36 months after ART We used logistic regression models to estimate viral suppression failure,and linear mixed effects models to analysisthe response characteristics of CD4+T lymphocyte(CD4),and Kaplan-Meier and cox hazard models to evaluate immunological failure.Findings1.5,331 patients met eligibility criteria.4,187(78.5%)participants were in the age group of 18-49 year-old,632(11.9%)were in the age group of 50-59 year-old,and 512(9.6%)were in the age group of ?60 year-old.People in the age group of 50-59 year-old had no statistically significant difference on viral suppression failure from those in the age group of 18-49 year-old(OR:1.11,95%CI:0.80-1.52).People in the age group of ?60 year-old had no statistically significant difference on viral suppression failure from those in the age group of 18-49 year-old(OR:1.25,95%CI:0.87-1.79).People in the age group of 50-59 year-old and ?60 year-old both had the lower CD4 counts than those in the age group of 18-49 year-old within 36 months after ART,and the solution for fixed effects of age were-16(P<.001)and-26(P<.001).The risk of immunological failure of people in the age group of 50-59 year-old was 1.44(95%CI:0.85-2.42)times higher than those in the age group of 18-49 year-old.The risk of immunological failure of people in the age group of>60 year-old was 1.92(95%CI:1.15-3.19)times higher than those in the age group of 18-49 year-old.2.Among the HIV/AIDS with different characteristcs,both the age group of 50-59 year-old and ?60 year-old had no statistically significant difference on viral suppression failure from the age group of 18-49 year-old(P>.005).3.Among the HIV/AIDS of female,of people whose initial treatment regime of Tenofovir(TDF),or of people with viral suppression failure status,the age group of 50-59 year-old and ?60 year-old had the similar CD4 counts with the age group of 18-49 year-old within 36 months after ART(P>.005).4.Among the HIV/AIDS of baseline CD4 counts<200/mm3,of male,of people with married or cohabiting marital status,of baseline CD4/CD8 ratio<0.30,of people whose initial treatment regime of AZT/d4T,or of people with viral suppression status,the age group of ?60 year-old was more likely to have immunological failure than the age group of 18-49 year-old within 36 months after ART,the corresponding aHR(95%CI)and the value of P were shown in Table 16.Among the HIV/AIDS with different characteristics,the age group of 50-59 years-old had no statistically significant difference on immunological failure from the age group of 18-49 year-old(P>.005).Conclusions1.We find no difference among three age groups on viral suppression failure within 36 months after ART.2.Either of people in the age group of 50-59 year-old or people in the age group of ?60 year-old had lower CD4 counts than those in the age group of 18-49 year-old within 36 months after ART.3.People in the age group of ?60 year-old were more likely to have immune failure.