[Survival and immune response of rural HIV/AIDS patients after free antiretroviral therapy].
OBJECTIVE
To assess the adherence, immunologic and survival responses in HIV-infected patients receiving free antiretroviral therapy (ART).


METHODS
All adult HIV-infected patients in Wenxi county who started antiretroviral treatment (ART) between 01 July 2001 and 31 December 2006 and aged above 18 years were included in this study. Epidemiological survey and laboratory tests were performed before, 0.5 months after, 1 months after, 2 months after and every 3 months after initiation of ART to recognize the adherence, efficacy (CD(4)(+) T cell counts) and survival to the regimens.


RESULTS
The median follow-up time period was 16.5 months (Interquartile: 15.5 - 20.8 months). At baseline, the median of CD(4)(+) T cell counts were 154 cells/microl (Interquartile: 81 - 212 cells/microl). Treatment was effective in most of the patients, the CD(4)(+) T cell count of patients increased after the initiation of ART. The maximum increase was recorded at month 3, from the median of 154 cells/microl to 220 cells/microl (P < 0.001), and thereafter the count remained stable. When comparing with patients with baseline CD(4)(+) T cell count > or = 100 cells/microl, those with baseline CD(4)(+) T cell count < 100 cells/microl showed a higher mean increase in the first three months of treatment. The cumulative probability rates of remaining alive were 0.94, 0.88 and 0.87 at 3, 12, 24 months, respectively. In multivariate Cox's proportional hazard models, after adjustment for the type ofinitial regimens (NVP vs. EFV/IDV), CD(+)(4) T cell count of less than 50 cells/microl (vs. 50 cells/microl or more) was strongly associated with death hazard ratio 0.21 (95%CI: 0.06 - 0.68).


CONCLUSIONS
Our data showed that ART was effective for improving immunologic response of adult patients with HIV/AIDS. CD(4)(+) T cell count at initiation was associated with survival time in patients starting ART, suggesting that monitoring of CD(4)(+) T count should be strengthened to early initiate antiretroviral therapy for HIV-infected patients.
Ding
Ying-ying
YY
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Jia
Wang-qian
WQ
Wang
Jin-sheng
JS
Dong
Shao-liang
SL
Yang
Qing-hai
QH
Zhou
Ren-yi
RY
Qu
Shu-xia
SX
Lu
Li-xing
LX
Wei
Jun
J
Qiao
Xiao-chun
XC
Gao
Mei-yang
MY
Guo
Xiao-li
XL
Zhang
Tie-jun
TJ
Wu
Zun-you
ZY
He
Na
N
D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005252:Fees, Pharmaceutical; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000401:mortality*; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012424:Rural Population; D016019:Survival Analysis
D019380:Anti-HIV Agents