title: Outcome of Sentinel Hospital-based and CDC-based ART Service Delivery: A Prospective Open Cohort of People Living with HIV in China.
abstract: The primary objective of this study was to obtain insights into the outcomes of people living with HIV who accessed services through HIV/AIDS sentinel hospital-based and ART service delivery in China. Post-hoc analyses of an open cohort from an observational database of 22 qualified HIV/AIDS sentinel hospital-based and two CDC-based drug delivery facilities (DDFs) in Guangdong Province was completed. Linkage to care, mortality and survival rates were calculated according to WHO criteria. 12,966 individuals received ART from HIV/AIDS sentinel hospitals and 1,919 from DDFs, with linkage to care rates of 80.7% and 79.9%, respectively (P > 0.05). Retention rates were 94.1% and 84.0% in sentinel hospitals and DDFs, respectively (P < 0.01). Excess mortality was 1.4 deaths/100 person-years (95% CI: 1.1, 1.8) in DDFs compared to 0.4 deaths/100 person-years (95% CI: 0.3, 0.5) in hospitals (P < 0.01). A Cox-regression analysis revealed that mortality was much higher in patients receiving ART from the DDFs than sentinel hospitals, with an adjusted HR of 3.3 (95% CI: 2.3, 4.6). A crude HR of treatment termination in DDFs was 7.5 fold higher (95% CI: 6.3, 9.0) compared to sentinel hospitals. HIV/AIDS sentinel hospital had better retention, and substantially lower mortality compared to DDFs.
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.|The University of North Carolina Project-China, Guangzhou, Guangdong, China.|Department of Infection Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|Medical Scientific Research Center &Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China.
authors.forename: Chuanyi
authors.initials: C
authors.lastname: Ning
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Kumi M
authors.initials: KM
authors.lastname: Smith
authors.affiliation: Department of Microbiology &Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Chase D
authors.initials: CD
authors.lastname: McCann
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Fengyu
authors.initials: F
authors.lastname: Hu
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lan
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Fuchun
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Medical Scientific Research Center &Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liang
authors.affiliation: Medical Scientific Research Center &Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China.
authors.forename: Jinmin
authors.initials: J
authors.lastname: Zhao
authors.affiliation: The University of North Carolina Project-China, Guangzhou, Guangdong, China.|Department of Infection Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.affiliation: Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.|The University of North Carolina Project-China, Guangzhou, Guangdong, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Cai
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D002681:China / Q000453:epidemiology; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D062306:Geography, Medical; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D062486:Public Health Surveillance; D055815:Young Adult