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. 2022 Mar 28;22(1):299.
doi: 10.1186/s12879-022-07281-x.

A comparative analysis on characteristics and mortalities of four key transmission populations on antiretroviral therapy: a retrospective cohort study in Northwest China

Shuo Feng  1 , Zirong Zhu  1 , Pengju Yang  1 , Juan Jin  2 , Huihui Tuo  1 , Ning Wang  1 , Ruimin Bai  1 , Yan Sun  1 , Liumei Song  1 , Xiu Zhang  1 , Shengbang Wang  1 , Qiqi Duan  1 , Yingjian Huang  1 , Yan Zheng  3 , Songhua Xu  4
Affiliations

A comparative analysis on characteristics and mortalities of four key transmission populations on antiretroviral therapy: a retrospective cohort study in Northwest China

Shuo Feng et al. BMC Infect Dis. .

Abstract

Background: This study explored disparities in characteristics and mortalities among four major transmission groups on antiretroviral therapy in northwest China as well as the survival impact of each transmission route.

Methods: We first examined disparities in demographics and clinical characteristics of the four transmission populations. Kaplan Meier analysis was subsequently conducted to compare survival rates among all groups. At last, Cox proportional hazards regression model was employed to analyze the survival impact of a transmission route among seven main categories of survival factors associated with all-cause mortalities.

Results: Survival analysis showed significant differences in all-cause, AIDS- and non-AIDS-related deaths among four HIV populations (all P < 0.05). Using homosexuals as the reference, Cox proportional hazards model further revealed that the risk of all-cause death for blood and plasma donors was significantly higher than that of the reference (aHR: 5.21, 95%CI: 1.54-17.67); the risk of non-AIDS-related death for heterosexuals (aHR: 2.07, 95%CI: 1.01-4.20) and that for blood and plasma donors (aHR: 19.81, 95%CI: 5.62-69.89) were both significantly higher than that of the reference.

Conclusions: Significant disparities were found in characteristics and mortalities among the four transmission groups where mortality disparities were mainly due to non-AIDS-related death. Suggestions are provided for each group to improve their survivorship.

Keywords: Antiretroviral therapy; Cohort study; HIV/AIDS; Homosexuals; Transmission category.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of Inclusion criteria of the participants. ART antiretroviral therapy, IDU injecting drug user
Fig. 2
Fig. 2
The proportion of PLWH stratified by transmission category (left) from January 2010 to June 2019 along with the number of PLWH initiating ART in each year (right). Note that for 2019, the number of PLWH drops because only half year’s data is available. PLWH people living with HIV, ART antiretroviral therapy, IDU injecting drug user
Fig. 3
Fig. 3
Comparing of baseline characteristics among four transmission categories, including (a) gender, (b) marital status, (c) WHO clinical stage, (d) comorbidity, (e) age at ART initiation, (f) interval between HIV diagnosis and ART initiation, (g) BMI, and (h) CD4 + lymphocyte counts. (Statistically significant pairwise comparison results are indicated using ∗ and highlighted in blue if 0.001 < P < 0.008 or indicated using ∗ ∗ and highlighted in red if P < 0.001. HMS homosexuals, HTS heterosexuals, IDU injecting drug user, BPD blood and plasma donors, ART antiretroviral therapy, BMI body mass index)
Fig. 4
Fig. 4
Kaplan–Meier survival curves for the four transmission populations for all-cause mortality (a), AIDS-related mortality (b), non-AIDS-related mortality stratified by HIV transmission category (c). ART antiretroviral therapy, IDU injecting drug user
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