title: Improved survival with co-trimoxazole prophylaxis among people living with HIV/AIDS who initiated antiretroviral treatment in Henan Province, China.
abstract: OBJECTIVE
  This study aims to evaluate the effect of co-trimoxazole (CTX) prophylaxis on mortality reduction among HIV-infected patients receiving antiretroviral therapy (ART) in Henan Province, China.
  
  
  METHODS
  We conducted a retrospective study.
  
  
  METHODS
  All individuals aged 15 years and older who initiated ART between 2008 and 2010 in Henan Province with completed CTX prophylaxis treatment information were included. The effect of CTX prophylaxis was estimated using Kaplan-Meier survival analysis and multivariate Cox proportional hazard modeling for mortality at 3-months and 12-months after ART initiation.
  
  
  RESULTS
  Overall mortality among patients receiving both ART and CTX was nearly double at 3-months after ART initiation compared with that at 12-months (12.4 per 100 PY vs 6.3 per 100 PY, p < 0.01). After adjusting for gender, age, TB history, year of ART initiation and CD4 count at ART initiation, CTX was associated with a significant reduction in 12-month mortality (adjusted hazard ratio (AHR) = 0.65, 95% confidence interval (CI): 0.44-0.95; p = 0.027) compared with persons not receiving CTX. The protective effect was more pronounced in the first 3 months after ART initiation (AHR = 0.53, 95% CI: 0.32-0.89; p = 0.017).
  
  
  CONCLUSIONS
  CTX prophylaxis together with ART reduced mortality of adult HIV patients during the first 12 months of ART in Henan Province, China. The effect was highest in the first 3 months of ART. CTX should be prescribed to all HIV-infected adults who initiate ART.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhu
authors.forename: Liming
authors.initials: L
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Lin
authors.forename: Marc
authors.initials: M
authors.lastname: Bulterys
authors.forename: Wenjie
authors.initials: W
authors.lastname: Yang
authors.forename: Dingyong
authors.initials: D
authors.lastname: Sun
authors.forename: Zhaolin
authors.initials: Z
authors.lastname: Cui
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kaplan
authors.forename: Nora
authors.initials: N
authors.lastname: Kleinman
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wei
authors.forename: Jessica
authors.initials: J
authors.lastname: Chung
authors.affiliation: Henan Provincial Center for Disease Control and Prevention, No.105 Nongye South Road, New District Zhengdong, Zhengzhou Prefecture, Henan Province 450016, China. zhe.1.wang@outlook.com.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination