Improved Survival with Co-Trimoxazole Prophylaxis among People Living with HIV/AIDS Who Initiated Antiretroviral Treatment in Henan Province, China

Title:Improved Survival with Co-Trimoxazole Prophylaxis among People Living with HIV/AIDS Who Initiated Antiretroviral Treatment in Henan Province, China

Volume: 12 Issue: 5

Author(s): Qian Zhu, Liming Wang, Wen Lin, Marc Bulterys, Wenjie Yang, Dingyong Sun, Zhaolin Cui, Jonathan Kaplan, Nora Kleinman, Xiaoyu Wei, Jessica Chung and Zhe Wang

Affiliation:

Keywords: ART, Co-trimoxazole, HIV, mortality, prophylaxis, survival.

Abstract: Objectives: This study aims to evaluate the effect of co-trimoxazole (CTX) prophylaxis on mortality reduction among HIV-infected patients receiving antiretroviral therapy (ART) in Henan Province, China.

Design: We conducted a retrospective study.

Methods: All individuals aged 15 years and older who initiated ART between 2008 and 2010 in Henan Province with completed CTX prophylaxis treatment information were included. The effect of CTX prophylaxis was estimated using Kaplan-Meier survival analysis and multivariate Cox proportional hazard modeling for mortality at 3-months and 12- months after ART initiation.

Results: Overall mortality among patients receiving both ART and CTX was nearly double at 3-months after ART initiation compared with that at 12-months (12.4 per 100 PY vs 6.3 per 100 PY, p<0.01). After adjusting for gender, age, TB history, year of ART initiation and CD4 count at ART initiation, CTX was associated with a significant reduction in 12-month mortality (adjusted hazard ratio (AHR) = 0.65, 95% confidence interval (CI): 0.44 – 0.95; p = 0.027) compared with persons not receiving CTX. The protective effect was more pronounced in the first 3 months after ART initiation (AHR = 0.53, 95% CI: 0.32 – 0.89; p = 0.017).

Conclusion: CTX prophylaxis together with ART reduced mortality of adult HIV patients during the first 12 months of ART in Henan Province, China. The effect was highest in the first 3 months of ART. CTX should be prescribed to all HIV-infected adults who initiate ART.

Cite this article as:

Zhu Qian, Wang Liming, Lin Wen, Bulterys Marc, Yang Wenjie, Sun Dingyong, Cui Zhaolin, Kaplan Jonathan, Kleinman Nora, Wei Xiaoyu, Chung Jessica and Wang Zhe, Improved Survival with Co-Trimoxazole Prophylaxis among People Living with HIV/AIDS Who Initiated Antiretroviral Treatment in Henan Province, China, Current HIV Research 2014; 12 (5) . https://dx.doi.org/10.2174/1570162X1205141121102155