title: [Progress on China' s national free antiretroviral therapy strategy in 2002-2014].
abstract: OBJECTIVE
  To analyze the progress and characteristics of China' s "Free AIDS treatment strategy" since the implementation of the national "four free and one care" policy against AIDS 12 years ago.
  
  
  METHODS
  Retrospective cohort study and cross-sectional analysis had been conducted in this study. 368 449 cases that had received the ' free antiviral therapy' from 2002 to 2014 were selected from the National Treatment Database. Data from the baseline (initial time of ART, CD(4) cell count, and antiretroviral regimen) and from the follow-up program (dates and status of follow-up, CD(4) cell counts) were gathered and analysed by SAS 9.3.
  
  
  RESULTS
  The number of cases that having received new treatment was increasing year by year, accounting for 75.4% of all the cases identified from 2010 to 2014. Constituent ratios of patients with baseline CD(4) cell count <200 cells/µl and clinical diagnosis of AIDS were decreasing from 81.0% in 2006 to 39.7 % in 2014. Status on drug optimization showed that: 3TC replaced DDI, EFV replaced NVP and TDF replaced D4T, making the utilization rates as 99.5%, 75.7%, and 60.6%, respectively, by 2014. Regions that were covered by the treatment accounted for 75.4% of all the counties/districts involved. The previous CDC-led AIDS treatment program and mode of management had been transferred to the hospital-based model. Proportion on the twice-CD(4)-testing model had been 75.2% since 2010, with the rate of virological detection increased from 70.8% in 2010 to 87.4% in 2014 and the virological unsuccessful testing rate decreased from 17.6% in 2010 to 11.8% in 2014. Among all the patients, the 1, 5 and 10 year survival rates appeared as 92.2%, 80.5% and 69.6%, respectively. For patients with baseline CD(4) cell counts as <50 cells/µl or >350 cells/µl, the corresponding survival rates showed as 81.6% , 69.9% , 60.9% and 97.9%, 89.8% , 81.0%, respectively.
  
  
  CONCLUSIONS
  China' s HIV/AIDS free antiretroviral therapy program appeared as a national treatment cohort which involved large number of participants, with new patients joining in, annually. Criterion on drug optimization and treatment were consistently following the recommendation and guidelines set by WHO. Management program on treatment had gradually turned to hospital-based, with follow-up and laboratory testing programs guaranteed, ended up with satisfactory treatment effects.
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors: Zhihui
authors: Z
authors: Dou
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Beijing Ditan Hospital, Capital Medical University.
authors: Fujie
authors: F
authors: Zhang
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors: Yan
authors: Y
authors: Zhao
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors: Canrui
authors: C
authors: Jin
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors: Decai
authors: D
authors: Zhao
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors: Xiumin
authors: X
authors: Gan
authors: National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Email: maye67@163.com.
authors: Ye
authors: Y
authors: Ma
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use; D002681:China; D003430:Cross-Sectional Studies; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D012189:Retrospective Studies
chemical_list: D044966:Anti-Retroviral Agents