Epidemiological trends of severely immunosuppressed people living with HIV at time of starting antiretroviral treatment in China during 2005-2018

Hou, Yuying1,2,3; Liu, Jiaye2,3,4; Zhao, Yan2; Wu, Yasong2; Ma, Ye2; Zhao, Decai2; Dou, Zhihui2; Liu, Zhongfu2; Shi, Ming3; Jiao, Yanmei3; Huang, Huihuang3; Wu, Zunyou2; Wang, Lifeng2,3; Han, Mengjie2; Wang, Fu-Sheng1,2,3,4

2022-03-01

10.1016/j.jinf.2021.12.034

JOURNAL OF INFECTION   影响因子和分区

0163-4453

1532-2742

["Objectives: High HIV-related mortality is mainly associated with severe immunosuppression (CD4 count < 50 cells/mu L) in people living with HIV (PLWH). This study intended to explore the trends in epidemic and early mortality among PLWH with severe immunosuppression for further targeted intervention.","Methods: We extracted the data of treatment-naive PLWH with severe immunosuppression from China's National Free Antiretroviral Treatment (ART) Program database. Early mortality (within 6 or 12 months after initiating ART) and spatial, temporal, and population distribution were analyzed during 2005-2018.","Results: Of 748,066 treatment-naive PLWH, 105,785 (14.1%) were severely immunosuppressed PLWH aged more than 15-year-old. The proportion of severely immunosuppressed PLWH peaked at 31.4% and then decreased with time, leveling offat approximately 11-12% from 2015 onward. Early mortality rates of these PLWH declined significantly (from 17.0% to 8.1% after 6 months of initiating ART; 20.4% to 10.6% after 12 months; both p values < 0.01) from 2005-2007 to 2016-2018. In the South-central and Southwest, the number of these PLWH was larger than that in the other regions during 2005-2018, and it increased to 4780 (37.1%) and 3370 (26.2%) in 2018. The proportion of PLWH aged 30-44 years among all treatment-naive severely immunosuppressed PLWH in each region was higher than that of other age groups during 2005-2018. After the proportion decreased during 2005-2007, the proportion of PLWH aged 45-59 years in Southwest and South-central were increased steadily from 11% (69/626) and 16.7% (358/2140) in 2007 to 33.8% (1138/3370) and 34.0% (1626/4780) in 2018, respectively; the proportion of PLWH aged >= 60 years showed an increasing trend during 2005-2018; while changes in the proportion of those age groups were less pronounced in North and Northeast. The proportion of PLWH infected by heterosexual contact was high at 83% (2798/3370) in Southwest, and 75.1% (3588/4780) in South-central in 2018; conversely, proportion of PLWH infected by homosexual contacts was largest in North (57.8% [500/865]) and Northeast (59.9% [561/936]).","Conclusions: The persistent burden of treatment-naive PLWH with severe immunosuppression remains challenging. Our results provide evidence for policy-makers to allocate resources and establish targeting strategies to identify early infection of PLWH. (C) 2021 Published by Elsevier Ltd on behalf of The British Infection Association."]

Hiv Aids Severe immunosuppression Real-world study

SCI

英语

通讯

National Science and Technology Major Project of the Ministry of Science and Technology of China["2017ZX10202102-004-0 02","2018ZX10302104-002"] ; Innovative Research Team in the National Natural Science Foundation of China[81721002] ; Peking University Clinical Scientist Program Special[BMU2019LCKXJ013]

Infectious Diseases

Infectious Diseases

WOS:000781133400016

W B SAUNDERS CO LTD

IMMUNOLOGY

Web of Science

1.Med Sch Chinese PLA, Beijing 100853, Peoples R China
2.China Ctr Dis Control & Prevent, Natl Ctr AIDS STD Control & Prevent, Beijing, Peoples R China
3.Peoples Liberat Army Gen Hosp, Med Ctr 5, Treatment & Res Ctr Infect Dis, Beijing 100039, Peoples R China
4.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Hosp 2, Dept Liver Dis, Shenzhen, Peoples R China

Hou, Yuying,Liu, Jiaye,Zhao, Yan,et al. Epidemiological trends of severely immunosuppressed people living with HIV at time of starting antiretroviral treatment in China during 2005-2018[J]. JOURNAL OF INFECTION,2022,84(3).

Hou, Yuying.,Liu, Jiaye.,Zhao, Yan.,Wu, Yasong.,Ma, Ye.,...&Wang, Fu-Sheng.(2022).Epidemiological trends of severely immunosuppressed people living with HIV at time of starting antiretroviral treatment in China during 2005-2018.JOURNAL OF INFECTION,84(3).

Hou, Yuying,et al."Epidemiological trends of severely immunosuppressed people living with HIV at time of starting antiretroviral treatment in China during 2005-2018".JOURNAL OF INFECTION 84.3(2022).