title: [Mortality rate and influencing factors among index partners of HIV discordant couples in the context of antiretroviral therapy, Zhumadian, Henan province, 2008-2014].
abstract: OBJECTIVE
  To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian, Henan province.
  
  
  METHODS
  An open and prospective cohort survey was conducted annually during 2008-2014. Information about the index partners ' demographic characteristics, CD4(+) T(CD4)cell counts, viral load, AIDS-related syndromes, date of therapy initiation, level of treatment institution, and outcome of death were collected. Life table was used to calculate survival rate, and Cox proportional hazards model was used to analyze the mortality related factors.
  
  
  RESULTS
  Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014, 350 were fatal, with the mortality rate of 1.88 per 100 person years(95%CI: 1.86-1.90). The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64%, 97.70%, 95.62%, 93.54%, 91.25%, 86.86% and 82.36% respectively. Factors related to the survival of the index partners of HIV discordant couples were age ≥ 50 years(HR=3.48, 95% CI: 2.67-4.55), junior high school or above education level(HR=0.75, 95% CI: 0.56-1.00), baseline CD4 cell counts >350 cells per μl(HR=0.55, 95% CI: 0.42-0.72), baseline viral load >400 copies/ml(HR=1.71, 95% CI: 1.32-2.22)and initiating treatment prior to cohort entry(HR=0.65, 95% CI: 0.41-1.05).
  
  
  CONCLUSIONS
  The mortality rate of index partners receiving antiretroviral therapy was relatively low, indicating a better effect of long-term treatment on patients' survival. It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy, improve the timeliness and adherence of the treatment, keeping patients' immunity level. Meanwhile, much attention should be paid to the drug resistance due to long term treatment and treatment failure.
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: F F
authors.initials: FF
authors.lastname: Chen
authors.affiliation: National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: S S
authors.initials: SS
authors.lastname: Jin
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: F
authors.initials: F
authors.lastname: Xu
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000401:mortality*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000401:mortality*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D006268:Health Facilities; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D017211:Treatment Failure; D019562:Viral Load