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Immunologic treatment failure among HIV-infected adult patients in Jiangsu province, China.

Immunologic treatment failure among HIV-infected adult patients in Jiangsu province, China.
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Qiu T, Ding P, Fu G, Huan X, Xu X, Zhang Z, Liu X, Yang H, Mandel J, Wei C, McFarland W, Yan H,


Qiu T, Ding P, Fu G, Huan X, Xu X, Zhang Z, Liu X, Yang H, Mandel J, Wei C, McFarland W, Yan H, (click to view)

Qiu T, Ding P, Fu G, Huan X, Xu X, Zhang Z, Liu X, Yang H, Mandel J, Wei C, McFarland W, Yan H,

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Scientific reports 2017 02 217() 42381 doi 10.1038/srep42381

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.

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