# 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.

## Key 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.