Mortality risk in the population of HIV-positive individuals in Southern China: A cohort study
To evaluate the mortality risk in the HIV-positive population, we conducted an observational cohort study involving routine data collection of HIV-positive patients who presented at HIV clinics and multiple treatment centers throughout Guangxi province, Southern China in 2011. The patients were scre...
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| Veröffentlicht in: | PloS one 2019-02, Vol.14 (2), p.e0210856 |
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| description | To evaluate the mortality risk in the HIV-positive population, we conducted an observational cohort study involving routine data collection of HIV-positive patients who presented at HIV clinics and multiple treatment centers throughout Guangxi province, Southern China in 2011. The patients were screened for tuberculosis (TB) and tested for hepatitis B (HBV) and C (HCV) virus infections yearly. Following the registration, the cohort was followed up for a 60-month period till the end-point (December 31, 2015). Univariable and multivariable Cox proportional hazards regression models were used to analyze the hazard ratio (HR) and 95% confidence interval (95% CI) for mortality after adjusting for confounding factors stratified by patients' sociodemographic and behavioral characteristics. HRs were compared within risk-factor levels. With the median follow-up of 3.7-person years for each individual, 5,398 (37.8%) (of 14,293 patients with HIV/AIDS) died; among whom, 78.4% were antiretroviral therapy (ART)-naïve; 43.6% presented late; and 12.2% and 3.3% of patients had Mycobacterium tuberculosis (MTB) and HBV and HCV co-infection, respectively. Of individuals with CD4 counts, those with CD4 count >350 cells/μL formed 14.0% of those who died. Furthermore, gender [multivariable HR (95% CI):1.94 (1.68-2.25)], Han ethnicity [2.15 (1.07-4.32)], illiteracy [3.28 (1.96-5.5)], elementary education [2.91 (1.8-4.72)], late presentation [2.89 (2.46-3.39)], and MTB co-infection [1.28 (1.10-1.49)] strongly increased the all-cause mortality risk of HIV-positive individuals. The HR for ART-based stratification was 0.08 (0.07-0.09); and for HBV and HCV co-infection, HR was 1.02 (0.86-1.21). The findings emphasized that accessibility to HIV testing among high-risk populations and screening for viral hepatitis and TB co-infection are important for the survival of HIV-positive individuals. Initiating early ART, even for individuals with higher CD4 counts, is advisable to help increase the prolongation of lives within the community. |
| doi_str_mv | 10.1371/journal.pone.0210856 |
| format | Article |
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The patients were screened for tuberculosis (TB) and tested for hepatitis B (HBV) and C (HCV) virus infections yearly. Following the registration, the cohort was followed up for a 60-month period till the end-point (December 31, 2015). Univariable and multivariable Cox proportional hazards regression models were used to analyze the hazard ratio (HR) and 95% confidence interval (95% CI) for mortality after adjusting for confounding factors stratified by patients' sociodemographic and behavioral characteristics. HRs were compared within risk-factor levels. With the median follow-up of 3.7-person years for each individual, 5,398 (37.8%) (of 14,293 patients with HIV/AIDS) died; among whom, 78.4% were antiretroviral therapy (ART)-naïve; 43.6% presented late; and 12.2% and 3.3% of patients had Mycobacterium tuberculosis (MTB) and HBV and HCV co-infection, respectively. Of individuals with CD4 counts, those with CD4 count >350 cells/μL formed 14.0% of those who died. Furthermore, gender [multivariable HR (95% CI):1.94 (1.68-2.25)], Han ethnicity [2.15 (1.07-4.32)], illiteracy [3.28 (1.96-5.5)], elementary education [2.91 (1.8-4.72)], late presentation [2.89 (2.46-3.39)], and MTB co-infection [1.28 (1.10-1.49)] strongly increased the all-cause mortality risk of HIV-positive individuals. The HR for ART-based stratification was 0.08 (0.07-0.09); and for HBV and HCV co-infection, HR was 1.02 (0.86-1.21). The findings emphasized that accessibility to HIV testing among high-risk populations and screening for viral hepatitis and TB co-infection are important for the survival of HIV-positive individuals. Initiating early ART, even for individuals with higher CD4 counts, is advisable to help increase the prolongation of lives within the community.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0210856</identifier><identifier>PMID: 30742626</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; Age Factors ; Aged ; AIDS ; Analysis ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Biology and Life Sciences ; CD4 antigen ; China ; China - epidemiology ; Cohort analysis ; Coinfection - mortality ; Confidence intervals ; Data collection ; Disease prevention ; Elementary education ; Female ; Follow-Up Studies ; Hazards ; Health aspects ; Health risk assessment ; Health risks ; Hepacivirus ; Hepatitis ; Hepatitis B ; Hepatitis B - mortality ; Hepatitis B virus ; Hepatitis C - mortality ; Hepatitis C virus ; Highly active antiretroviral therapy ; HIV ; HIV patients ; HIV Seropositivity - mortality ; HIV-1 ; Human immunodeficiency virus ; Humans ; Infections ; Medicine and Health Sciences ; Middle Aged ; Minority & ethnic groups ; Mortality ; Mycobacterium tuberculosis ; Patients ; Prolongation ; Regression analysis ; Regression models ; Risk Factors ; Sex Factors ; Social Sciences ; Statistical analysis ; Tuberculosis ; Tuberculosis - mortality ; Viral hepatitis ; Viruses</subject><ispartof>PloS one, 2019-02, Vol.14 (2), p.e0210856</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Zheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Zheng et al 2019 Zheng et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c659t-a688c2aa7596ee71e01cc20fe3a72df66e8d81581d8064a5624236cfef15298c3</citedby><cites>FETCH-LOGICAL-c659t-a688c2aa7596ee71e01cc20fe3a72df66e8d81581d8064a5624236cfef15298c3</cites><orcidid>0000-0001-8627-1263</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370196/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370196/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30742626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zheng, Zhigang</creatorcontrib><creatorcontrib>Lin, Jinying</creatorcontrib><creatorcontrib>Lu, ZhenZhen</creatorcontrib><creatorcontrib>Su, Jinming</creatorcontrib><creatorcontrib>Li, Jianjun</creatorcontrib><creatorcontrib>Tan, Guangjie</creatorcontrib><creatorcontrib>Zhou, Chongxing</creatorcontrib><creatorcontrib>Geng, Wenkui</creatorcontrib><title>Mortality risk in the population of HIV-positive individuals in Southern China: A cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To evaluate the mortality risk in the HIV-positive population, we conducted an observational cohort study involving routine data collection of HIV-positive patients who presented at HIV clinics and multiple treatment centers throughout Guangxi province, Southern China in 2011. The patients were screened for tuberculosis (TB) and tested for hepatitis B (HBV) and C (HCV) virus infections yearly. Following the registration, the cohort was followed up for a 60-month period till the end-point (December 31, 2015). Univariable and multivariable Cox proportional hazards regression models were used to analyze the hazard ratio (HR) and 95% confidence interval (95% CI) for mortality after adjusting for confounding factors stratified by patients' sociodemographic and behavioral characteristics. HRs were compared within risk-factor levels. With the median follow-up of 3.7-person years for each individual, 5,398 (37.8%) (of 14,293 patients with HIV/AIDS) died; among whom, 78.4% were antiretroviral therapy (ART)-naïve; 43.6% presented late; and 12.2% and 3.3% of patients had Mycobacterium tuberculosis (MTB) and HBV and HCV co-infection, respectively. Of individuals with CD4 counts, those with CD4 count >350 cells/μL formed 14.0% of those who died. Furthermore, gender [multivariable HR (95% CI):1.94 (1.68-2.25)], Han ethnicity [2.15 (1.07-4.32)], illiteracy [3.28 (1.96-5.5)], elementary education [2.91 (1.8-4.72)], late presentation [2.89 (2.46-3.39)], and MTB co-infection [1.28 (1.10-1.49)] strongly increased the all-cause mortality risk of HIV-positive individuals. The HR for ART-based stratification was 0.08 (0.07-0.09); and for HBV and HCV co-infection, HR was 1.02 (0.86-1.21). The findings emphasized that accessibility to HIV testing among high-risk populations and screening for viral hepatitis and TB co-infection are important for the survival of HIV-positive individuals. Initiating early ART, even for individuals with higher CD4 counts, is advisable to help increase the prolongation of lives within the community.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Biology and Life Sciences</subject><subject>CD4 antigen</subject><subject>China</subject><subject>China - epidemiology</subject><subject>Cohort analysis</subject><subject>Coinfection - mortality</subject><subject>Confidence intervals</subject><subject>Data collection</subject><subject>Disease prevention</subject><subject>Elementary education</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hazards</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hepacivirus</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis B - mortality</subject><subject>Hepatitis B virus</subject><subject>Hepatitis C - mortality</subject><subject>Hepatitis C virus</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV patients</subject><subject>HIV Seropositivity - mortality</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>Mortality</subject><subject>Mycobacterium tuberculosis</subject><subject>Patients</subject><subject>Prolongation</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Social Sciences</subject><subject>Statistical analysis</subject><subject>Tuberculosis</subject><subject>Tuberculosis - mortality</subject><subject>Viral hepatitis</subject><subject>Viruses</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1rFDEYhQdRbK3-A9EBQfBi13xMPsYLYVmqXagUrPbSkCaZnayzkzHJLN1_b8adlh1QkFwkJM85bzicLHsJwRxiBt9vXO9b2cw715o5QBBwQh9lp7DEaEYRwI-PzifZsxA2ABDMKX2anWDACkQRPc1-fHE-ysbGfe5t-JnbNo-1yTvX9Y2M1rW5q_KL1c2sc8FGuzOJ0HZndS-bMNDXrk8C3-bL2rbyQ77IlauTZx5ir_fPsydVAs2LcT_Lvn86_7a8mF1efV4tF5czRUkZZ5JyrpCUjJTUGAYNgEohUBksGdIVpYZrDgmHmgNaSEJRgTBVlakgQSVX-Cx7ffDtGhfEGE0QCDJOOC05TMTqQGgnN6Lzdiv9XjhpxZ8L59dC-mhVYwQoFNasLJAmRQG1uaW6KikkkJUlwniY9nGc1t9ujVamjV42E9PpS2trsXY7QTEDsKTJ4M1o4N2v3oT4jy-P1FqmX9m2cslMbW1QYkEYTslxzBI1_wuVljZbq1I5KpvuJ4J3E0FiormLa9mHIFbXX_-fvbqZsm-P2NrIJtbBNf3QojAFiwOovAvBm-ohOQjE0O37NMTQbTF2O8leHaf-ILovM_4NURDzvQ</recordid><startdate>20190211</startdate><enddate>20190211</enddate><creator>Zheng, Zhigang</creator><creator>Lin, Jinying</creator><creator>Lu, ZhenZhen</creator><creator>Su, Jinming</creator><creator>Li, Jianjun</creator><creator>Tan, Guangjie</creator><creator>Zhou, Chongxing</creator><creator>Geng, Wenkui</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8627-1263</orcidid></search><sort><creationdate>20190211</creationdate><title>Mortality risk in the population of HIV-positive individuals in Southern China: A cohort study</title><author>Zheng, Zhigang ; Lin, Jinying ; Lu, ZhenZhen ; Su, Jinming ; Li, Jianjun ; Tan, Guangjie ; Zhou, Chongxing ; Geng, Wenkui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c659t-a688c2aa7596ee71e01cc20fe3a72df66e8d81581d8064a5624236cfef15298c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Biology and Life Sciences</topic><topic>CD4 antigen</topic><topic>China</topic><topic>China - 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The patients were screened for tuberculosis (TB) and tested for hepatitis B (HBV) and C (HCV) virus infections yearly. Following the registration, the cohort was followed up for a 60-month period till the end-point (December 31, 2015). Univariable and multivariable Cox proportional hazards regression models were used to analyze the hazard ratio (HR) and 95% confidence interval (95% CI) for mortality after adjusting for confounding factors stratified by patients' sociodemographic and behavioral characteristics. HRs were compared within risk-factor levels. With the median follow-up of 3.7-person years for each individual, 5,398 (37.8%) (of 14,293 patients with HIV/AIDS) died; among whom, 78.4% were antiretroviral therapy (ART)-naïve; 43.6% presented late; and 12.2% and 3.3% of patients had Mycobacterium tuberculosis (MTB) and HBV and HCV co-infection, respectively. Of individuals with CD4 counts, those with CD4 count >350 cells/μL formed 14.0% of those who died. Furthermore, gender [multivariable HR (95% CI):1.94 (1.68-2.25)], Han ethnicity [2.15 (1.07-4.32)], illiteracy [3.28 (1.96-5.5)], elementary education [2.91 (1.8-4.72)], late presentation [2.89 (2.46-3.39)], and MTB co-infection [1.28 (1.10-1.49)] strongly increased the all-cause mortality risk of HIV-positive individuals. The HR for ART-based stratification was 0.08 (0.07-0.09); and for HBV and HCV co-infection, HR was 1.02 (0.86-1.21). The findings emphasized that accessibility to HIV testing among high-risk populations and screening for viral hepatitis and TB co-infection are important for the survival of HIV-positive individuals. Initiating early ART, even for individuals with higher CD4 counts, is advisable to help increase the prolongation of lives within the community.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30742626</pmid><doi>10.1371/journal.pone.0210856</doi><tpages>e0210856</tpages><orcidid>https://orcid.org/0000-0001-8627-1263</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-02, Vol.14 (2), p.e0210856 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2178586981 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Adolescent Adult Age Factors Aged AIDS Analysis Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Biology and Life Sciences CD4 antigen China China - epidemiology Cohort analysis Coinfection - mortality Confidence intervals Data collection Disease prevention Elementary education Female Follow-Up Studies Hazards Health aspects Health risk assessment Health risks Hepacivirus Hepatitis Hepatitis B Hepatitis B - mortality Hepatitis B virus Hepatitis C - mortality Hepatitis C virus Highly active antiretroviral therapy HIV HIV patients HIV Seropositivity - mortality HIV-1 Human immunodeficiency virus Humans Infections Medicine and Health Sciences Middle Aged Minority & ethnic groups Mortality Mycobacterium tuberculosis Patients Prolongation Regression analysis Regression models Risk Factors Sex Factors Social Sciences Statistical analysis Tuberculosis Tuberculosis - mortality Viral hepatitis Viruses |
| title | Mortality risk in the population of HIV-positive individuals in Southern China: A cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T06%3A42%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mortality%20risk%20in%20the%20population%20of%20HIV-positive%20individuals%20in%20Southern%20China:%20A%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Zheng,%20Zhigang&rft.date=2019-02-11&rft.volume=14&rft.issue=2&rft.spage=e0210856&rft.pages=e0210856-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0210856&rft_dat=%3Cgale_plos_%3EA573659837%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2178586981&rft_id=info:pmid/30742626&rft_galeid=A573659837&rft_doaj_id=oai_doaj_org_article_04c3d7942d5441deb6df96151799233c&rfr_iscdi=true |