title: Immunologic treatment failure among HIV-infected adult patients in Jiangsu province, China.
abstract: The National Free Antiretroviral Treatment Program was implemented in Jiangsu Province, China in 2005. We conducted a retrospective, open cohort study to determine treatment failure rates and associated risk factors. Data were obtained from the national web-based antiretroviral treatment database. WHO criteria were used to define immunologic treatment failure. Kaplan-Meier methods were used to determine treatment failure rates and Cox proportional hazards modeling was used to identify risk factors. A total of 5,083 (87.8%) having at least one CD4 cell count measure were included from 2005 to 2013. Overall, 30.4% had immunologic treatment failure with cumulative treatment failure rates increasing to 50.5% at month 60 and 64.1% at month 90. Factors predicting treatment failure included being treated in the Centers for Disease Control and Prevention system (HR 1.69, 95% CI 1.14-2.50, p = 0.009) or jail hospital (HR 1.20, 95% CI 1.08-1.34, p = 0.001), and having a baseline CD4 count >350 cells/uL (HR 2.37, 95% CI 1.94-2.89. p < 0.001). Immunologic treatment failure was moderate to substantial among treated HIV patients. Providing second-line regimens and shifting treatment providers to professional hospitals should be considered to consolidate gains in averting morbidity and mortality.
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Qiu
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Ding
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Gengfeng
authors.initials: G
authors.lastname: Fu
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Huan
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Jiangsu Institute of Parasite Diseases, Wuxi, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Yang
authors.affiliation: Global Health Sciences, University of California, San Francisco, California, USA.
authors.forename: Jeff
authors.initials: J
authors.lastname: Mandel
authors.affiliation: Global Health Sciences, University of California, San Francisco, California, USA.
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.affiliation: Global Health Sciences, University of California, San Francisco, California, USA.
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.affiliation: Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, 210009, China.
authors.forename: Hongjing
authors.initials: H
authors.lastname: Yan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D018791:CD4 Lymphocyte Count; D002681:China; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy* / Q000821:virology; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D019562:Viral Load; D055815:Young Adult