Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Front Public Health. 2022 Jun 9;10:902537. doi: 10.3389/fpubh.2022.902537. eCollection 2022.
HIV epidemiology in South-Central China is rarely reported. This study aims to characterize epidemiological and clinical features of HIV-infected patients in Hunan Province, located in South-Central China, for better management of HIV infections.
This retrospective study retrieved multi-center records of laboratory-confirmed HIV-infected patients in Hunan province. Information on HIV-associated mortality and antiretroviral therapies was also collected.
Among 34,297 patients diagnosed with HIV infections from 2003 to 2018, 73.9% were males, 41.3% were older adults (≥50 years), and 71.2% were infected by heterosexual transmission. Despite a slow growth of new HIV infections in the overall population, annual percentages of HIV infections increased in older males (85.3% through heterosexual transmission) and young patients <30 years (39.9% through homosexual transmission). At baseline, serum levels of CD4+ T-cell counts were lower in older adults (191.0 cells/μl) than in young patients (294.6 cells/μl, -value < 0.0001). A large proportion (47.2%, = 16,165) of HIV-infected patients had advanced HIV disease (CD4+ T-cell counts < 200 cells/μl) from 2003 to 2018. All-cause mortality (57.0% due to AIDS-related illnesses) was reported among 4411 HIV-infected patients, including 2619 older adults. The 10-year survival rate was significantly lower in elderly males than in other patients (59.0 vs. 78.4%, -value < 0.05).
Elderly males are prone to HIV infections with a high risk of HIV-associated fatality. Our findings support early prevention and critical care for elderly populations to control HIV infections.
中国中南地区的 HIV 流行病学情况鲜见报道。本研究旨在描述中国中南地区湖南省 HIV 感染者的流行病学和临床特征，以更好地管理 HIV 感染。
本回顾性研究检索了湖南省多家中心实验室确诊的 HIV 感染者的多中心记录。还收集了与 HIV 相关的死亡率和抗逆转录病毒治疗信息。
在 2003 年至 2018 年间诊断出的 34297 名 HIV 感染者中，73.9%为男性，41.3%为老年人（≥50 岁），71.2%为异性传播感染。尽管总人口中新发 HIV 感染的增长率缓慢，但老年男性（85.3%通过异性传播）和年轻患者（<30 岁）（39.9%通过同性传播）的 HIV 感染年增长率呈上升趋势。在基线时，老年患者（191.0 个细胞/μl）的血清 CD4+ T 细胞计数低于年轻患者（294.6 个细胞/μl，-值<0.0001）。从 2003 年到 2018 年，大量（47.2%，=16165）HIV 感染者患有晚期 HIV 疾病（CD4+ T 细胞计数<200 个细胞/μl）。在 4411 名 HIV 感染者中报告了全因死亡率（57.0%归因于艾滋病相关疾病），其中包括 2619 名老年人。老年男性的 10 年生存率明显低于其他患者（59.0%比 78.4%，-值<0.05）。
老年男性易感染 HIV，且与 HIV 相关的病死率较高。我们的研究结果支持对老年人群进行早期预防和重症监护，以控制 HIV 感染。
