Objective: To study the effect of a government-provided-free highly active antiretroviral treatment (HAART) program, on the reduction of mortality and relevant risk factors among adult (AIDS) patients in Henan province.
Methods: Data on the survival and deaths of AIDS patients were collected from the National HAART reporting system between 2003 and 2009. Cox proportional hazards model was applied to analyze those factors that affecting the survival time of the patients.
Results: 24 669 cases were enrolled to this study in Henan province, from 2003 to 2009. The overall mortality declined from 20.1/100 person-years in 2003 to 5.1/100 person-years in 2009. There was significant difference between the survival curves of different CD4(+)T counts and different numbers of opportunistic infection syndromes. Results from the Multivariate Cox proportional hazards regression analysis indicated that CD4(+) T cell counts (> 200 cells/µl, 50 - 199 cells/µl) was a risk factor to death, with hazard ratio as 4.4 and 2.0 respectively. Hb of the patients that lower than 90, was a risk factor to death with the HR = 1.8. Number of opportunistic infection (OIs) episodes was a risk factor to the mortality (HR = 1.7). In addition, other risk factors would include age (≥ 60 years, old), being male, unmarried or divorced, ALT > 100 µl, and other routes of infection, other than Former Plasma Donors (FPDs), with HR as 2.2, 1.6, 1.5, 1.3 and 1.2. However, the protective factors would include: (1) the earlier the HAART began, the longer the survival time would last (HR = 0.8); (2) when one spouse had already had the infection of HIV, it seemed helpful for the other spouse to live longer (HR = 0.8).
Conclusion: The National Free Treatment Program had significantly reduced the AIDS mortality rate. Some effective measures should be further taken to monitor the CD4(+)T and the opportunistic infection of the AIDS patients. Patients who were in need to take the HARRT should be adopted into the ART timely, At the same time, the occurrence of opportunistic infections should be actively prevented.