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Current HIV Research

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ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

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Research Article

Mortality Risk Factors Among People Living with HIV Receiving Second-line Antiretroviral Therapy in Rural China

Author(s): Qiujia Kang, Wanqi Pan, Yanmin Ma, Dongli Wang, Huangchao Jia, Huijun Guo, Feng Sang, Liran Xu, Qianlei Xu* and Yantao Jin*

Volume 22, Issue 2, 2024

Published on: 19 January, 2024

Page: [100 - 108] Pages: 9

DOI: 10.2174/011570162X280721240108065502

Price: $65

Abstract

Background: Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing.

Objective: This study aimed to investigate the survival and factors affecting mortality among this group.

Methods: We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan–Meier method and Cox proportional hazards models.

Results: We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55–0.79), > 50 years old (HR, 2.69; 95% CI, 2.03–3.56), single/widowed (HR, 1.26; 95% CI, 1.04–1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65–0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52–0.96), liver injury (HR, 1.58; 95% CI, 1.19–2.10), and CD4+ T cell count <200 cells/μl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/μl (HR, 1.37; 95% CI, 1.03–1.82) were associated with mortality risk.

Conclusions: We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.

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Graphical Abstract

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