Survival outcomes and influencing factors in Zhengzhou HIV/AIDS patients following antiretroviral therapy initiation (2014-2024): a retrospective cohort analysis

TL;DR

This study analyzed survival rates and risk factors for HIV patients in Zhengzhou who started antiretroviral therapy from 2014 to 2024.

Contribution

The study identifies advanced age and low baseline CD4+ T cell count as significant risk factors for mortality in HIV patients on ART in Zhengzhou.

Findings

Cumulative survival rates at 1, 3, 5, and 10 years were 99%, 98%, 96%, and 93%, respectively.

Age over 60 years increased mortality risk (HR = 5.570).

Low baseline CD4+ T lymphocyte count (<50 cells/μL) significantly increased mortality risk (HR = 3.777).

Abstract

While antiretroviral therapy (ART) has significantly improved the long-term survival of people living with HIV/AIDS, leading to a chronic disease management model, survival outcomes can be influenced by demographic and clinical factors. There is a need to evaluate the long-term survival of HIV-infected individuals initiating ART and identify local influencing factors to optimize patient management and improve prognosis.

A retrospective cohort study was conducted on HIV-infected individuals who initiated ART in Zhengzhou between 2014 and 2024. Demographic data and ART-related information were collected from the National AIDS Clinical Data System. The life table method was employed to describe patient survival time, while the Kaplan-Meier method was used to compare survival time differences under various conditions and to plot survival curves. A Cox proportional hazards regression model was applied to analyze risk factors influencing patient survival time.

Among the 3,312 HIV-infected individuals, the total follow-up time amounted to 15,656.5 person-years, with a median follow-up of 4.73 years. A total of 107 deaths were recorded, yielding a mortality rate of 0.68 per 100 person-years. The cumulative survival rates at 1, 3, 5, and 10 years were 99%, 98%, 96%, and 93%, respectively. Multivariate Cox regression analysis identified age greater than 60 years (HR = 5.570, 95% CI: 1.608–19.292) as a risk factor for mortality. Additionally, patients with a baseline CD4+ T lymphocyte count of less than 50 cells/μL faced a significantly higher risk of death compared to those with a count greater than 350 cells/μL (HR = 3.777, 95% CI: 1.583–9.014).

From 2014 to 2024, the overall survival of HIV-infected individuals receiving antiviral therapy in Zhengzhou was favorable. However, advanced age and a low baseline CD4+ T lymphocyte count were identified as significant factors for an elevated mortality risk. It is recommended to enhance clinical management for older patients and to initiate treatment early to improve CD4+ T lymphocyte levels, thereby further improving survival outcomes.

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