Survival analysis of PLWH on antiretroviral therapy in Henan Province from 2004 to 2024

Abstract

There is a significant gap in data regarding the survival time and the factors influencing the survival of people living with HIV (PLWH) undergoing antiretroviral therapy (ART) in Henan Province, a region severely impacted by the AIDS epidemic.Investigating survival and influencing factors after ART can provide valuable insights to enhance patient management strategies and improve the prognosis for PLWH.This retrospective cohort study compiled case data and follow-up records of PLWH receiving ART at the Infectious Disease Hospital of Henan Province between 2004 and 2024. Survival curves were generated using the Kaplan-Meier method, and both univariate and multivariate Cox proportional hazards models were employed to identify factors influencing survival outcomes. Among the 4,307 study participants, a total of 251 (5.83%) patients died. The overall cumulative survival rate to the observation endpoint was 80%. The multifactorial Cox proportional risk regression modeling analysis of the primary outcomes showed that patients aged > 60 years at diagnosis of HIV/AIDS (HR = 4.706, 95% CI: 2.175 ~ 10.180), transmission route of heterosexual (HR = 1.403, 95% CI: 1.021 ~ 1.928) and blood transmission (HR = 1.855, 95% CI:1.206 ~ 2.855), patients with CD4⁺ T cell count < 200cells/µL (HR = 1.636,95% CI: 1.136 ~ 2.354) had a higher risk of death. Our findings highlight the importance of targeted ART management for high-risk populations, such as older individuals, heterosexual or blood-borne transmission and those with low CD4⁺ T cell count, to further improve survival outcomes and optimize HIV/AIDS treatment strategies.

Keywords: Acquired immunodeficiency syndrome; Antiretroviral therapy; Human immunodeficiency virus; Survival analysis.

Fig. 1

Survival curves showing intergroup differences with respect to(A)Cumulative Survival Probability, (B)Age at diagnosis, (C)Marital status, (D)WHO clinical staging at ART initiation, (E)Infection route, (F)Baseline CD4⁺ T cell count).