Shandong University School of Public Health, Jinan, Shandong, China.
Lu'an Center for Disease Control and Prevention, Lu'an, Anhui, China.
Med Sci Monit. 2024 Jul 23;30:e944727. doi: 10.12659/MSM.944727.
BACKGROUND There are many factors that affect human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)-related deaths, and different antiretroviral therapy (ART) strategies may affect HIV/AIDS-related fatality rates. However, studies on this area are very limited. This study aimed to evaluate the factors associated with HIV/AIDS-related mortality and the impact of different ART strategies in Lu'an City, Anhui Province, China, 1999-2023. MATERIAL AND METHODS Data of HIV/AIDS cases were downloaded from the China HIV/AIDS Comprehensive Response Information Management System, and were assessed to evaluate the impact of different ART strategies on the related fatality rate using interrupted time series (ITS). RESULTS We found that age at diagnosis of 15 years, 25 years, 40 years, and 60 years, as well as receiving ART, were protective factors against death (with P below 0.05), while lower CD4 count at the last CD4 count and the year of diagnosis before 2007 and between 2007 and 2016 were risk factors (with P below 0.05). ITS analysis revealed that in the year of the introduction of free ART in 2006, the fatality rate decreased by 38.60% (P=0.015). The fatality rate trend from 2006 to 2015 was -1.1%, which was not statistically significant (P=0.434). The fatality rate trend from 2016 to 2023 was -0.33%, indicating a decreasing trend (P=0.000). CONCLUSIONS Children under 15 years old and elderly patients had a higher risk of death. The main reasons for the decrease in HIV/AIDS-related fatality rate were ART, especially the "early treatment" strategy.
影响人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）相关死亡的因素很多，不同的抗逆转录病毒治疗（ART）策略可能会影响 HIV/AIDS 相关病死率。然而，这方面的研究非常有限。本研究旨在评估与 HIV/AIDS 相关死亡相关的因素，以及中国安徽省六安市 1999-2023 年不同 ART 策略的影响。
从中国 HIV/AIDS 综合应对信息管理系统下载 HIV/AIDS 病例数据，并进行评估，采用中断时间序列（ITS）评估不同 ART 策略对相关病死率的影响。
我们发现，诊断时年龄为 15 岁、25 岁、40 岁和 60 岁，以及接受 ART，是死亡的保护因素（P 均<0.05），而最后一次 CD4 计数较低、诊断前一年在 2007 年之前和 2007 年至 2016 年期间为风险因素（P 均<0.05）。ITS 分析显示，2006 年免费 ART 引入当年病死率下降了 38.60%（P=0.015）。2006 年至 2015 年的病死率趋势为-1.1%，无统计学意义（P=0.434）。2016 年至 2023 年的病死率趋势为-0.33%，呈下降趋势（P=0.000）。
15 岁以下儿童和老年患者死亡风险较高。HIV/AIDS 相关病死率下降的主要原因是 ART，特别是“早期治疗”策略。
