Analysis on survival time of HIV/AIDS cases and related factors in Wenzhou, 1985-2016

Objective To understand the all-cause mortality and risk factors among HIV/AIDS cases in Wenzhou, Zhejiang province, from 1985 to 2016. Methods A retrospective cohort study was conducted among HIV/AIDS cases living in Wenzhou and reported from 1 January 1985 to 31 December 2016. All the information about death was collected to calculate the survival rate and all-cause mortality by life table. Kaplan-Meier method was used to compare the survival time of different groups and Cox proportional hazards model was used to analyze the influencing factors of survival time. Results A total of 3 381 HIV/AIDS patients were enrolled in the study cohort.The cumulative person-year was 9 885.50 years and the all-cause mortality rate was 5.20 per 100 person-year. All-cause mortality began to fall in 2006 and showed a continuing downward trend. The average survival time was 16.35 years (95%CI: 14.848－17.858).The cumulative survival rates of HIV/AIDS cases in the first 1, 5 and 10 years were 89.64%, 83.60% and 80.58% respectively in the antiviral treatment group, and 89.64%, 64.44% and 40.36% respectively in the untreated group. Cox multivariate analysis showed that age, occupation, route of infection, antiviral treatment, first CD4 count and sample source were the factors influencing the survival time. The death risks in age groups 15－, 30－, 45－ years were lower than that in age group 60 years. The death risk was lower in patients who were service staff/students and detected by CDC, those received antiretroviral therapy, those with first CD4 count 100 /mm3 than in those who were farmers and found by medical institutions, those receiving no antiretroviral therapy and those with first CD4 count 100 /mm3. Conclusion The all-cause mortality of HIV/AIDS patients decreased year by year. It is necessary to strengthen the health education about AIDS and HIV antibody detection to improve the rates of early HIV diagnosis and timely treatment to prolong the survival time and reduce the all-cause mortality of patients.