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[Study on the mortality and risk factors among HIV/AIDS patients receiving antiretroviral therapy in Xinjiang Uygur Autonomous Region].

OBJECTIVE
To analyze the mortality and risk factors among HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) in the Xinjiang Uyghur Autonomous Region (XUAR).


METHODS
The objects of study were all HIV/AIDS adult patients who had received HAART in XUAR. The proceeding information was uploaded to the national ART reporting system which was a branch of the national HIV/AIDS reporting system. A retrospective cohort study was conducted among these patients who were treated during July 2004 to June 2013 in XUAR. Mortality rates and cumulative survival rates were calculated. Cox proportional hazard model was conducted to examine the risk factors for deaths.


RESULTS
The proportion for death, lost, referral and withdrawal were 8.5% (1 200/14 062), 2.5% (351/14 062), 0.9% (121/14 062)and 15.4% (2 162/14 062) respectively. The P25, P50 and P75 of baseline CD4(+)T lymphocyte was 144.00, 244.50 and 331.00/µl, respectively. The overall mortality rate was 4.98/100 person-years. The cumulative survival rate of ART treatment after 1-5 years were 0.94,0.91,0.88, 0.84 and 0.81. The mortality rate had a significant difference among different population. The male (6.58/100 person-years) was higher than the female(2.87/100 person-years), the people who infected tuberculosis (TB) (9.79/100 person-years) was higher than those non TB (4.12/100 person-years), the people whose CD4(+)T lymphocyte count less than 200/µl (7.67/100 person-years) was higher than other groups, the people who were transmitted through injection (7.61/100 person-years) was higher than those sexual transmission (3.10/100 person-years), the people whose HB less than 80 g/L (13.84/100 person-years) was higher than those more than 80 g/L (4.74/100 person-years) (χ(2) values were 154.62, 177.47, 309.73, 228.99 and 84.27. P < 0.01). The risk of death of the one with the baseline CD4(+)T lymphocyte ≤ 200/µl was 3.61 (2.73-4.78) times of the one with the baseline CD4(+)T lymphocyte >350/µl. The risk of death of the one having more than 4 baseline symptom categories was 3.62 (2.42-5.42) times of the one having less than 3 baseline symptom categories. The risk of death of the one with baseline HB ≥ 80 g/L was 2.84 (2.21-3.64) times of the one with the baseline HB <80 g/L. The risk of death of the male was 1.48 (1.25-1.75) times of the female. The risk of death of the one infected TB was 1.39(1.18-1.64) times of the one not infected TB. The risk of death of the one injecting drugs was 1.84 (1.56-2.17) times of the one not injecting drugs.


CONCLUSION
From 2004 to 2013, the mortality rate was low among HIV/AIDS patients receiving ART in XUAR. The mortality risk factors were low CD4 T cell count, having more baseline symptom categories, low HB level, injection drug transmission, male and TB infection, all these factors had positive correlation with death.