Journal ArticleDOI
Effect of earlier initiation of antiretroviral treatment and increased treatment coverage on HIV-related mortality in China: a national observational cohort study
Fujie Zhang,Fujie Zhang,Zhihui Dou,Ye Ma,Yao Zhang,Yan Zhao,Decai Zhao,Shuntai Zhou,Marc Bulterys,Hao Zhu,Hao Zhu,Ray Y. Chen +11 more
TLDR
Wang et al. as mentioned in this paper used data from the national HIV epidemiology and treatment databases to identify individuals aged 15 years or older with HIV who were eligible for highly active antiretroviral therapy between 1985 and 2009.Abstract:
Summary Background Overall HIV mortality rates in China have not been reported. In this analysis we assess overall mortality in treatment-eligible adults with HIV and attempt to identify risk factors for HIV-related mortality. Methods We used data from the national HIV epidemiology and treatment databases to identify individuals aged 15 years or older with HIV who were eligible for highly active antiretroviral therapy between 1985 and 2009. Mortality rates were calculated in terms of person-years, with risk factors determined by Cox proportional hazard regression. Treatment coverage was calculated as the proportion of time that patients who were eligible for treatment received treatment, with risk factors for not receiving treatment identified by use of logistic regression. Findings Of 323 252 people reported as having HIV in China by the end of 2009, 145 484 (45%) were identified as treatment-eligible and included in this analysis. Median CD4 count was 201 cells per μL (IQR 71–315) at HIV diagnosis and 194 cells per μL (73–293) when first declared eligible for treatment. Overall mortality decreased from 39·3 per 100 person-years in 2002 to 14·2 per 100 person-years in 2009, with treatment coverage concomitantly increasing from almost zero to 63·4%. By 2009, mortality was higher and treatment coverage lower in injecting drug users (15·9 deaths per 100 person-years; 42·7% coverage) and those infected sexually (17·5 deaths per 100 person-years; 61·7% coverage), compared with those infected through plasma donation or blood transfusion (6·7 deaths per 100 person-years; 80·2% coverage). The two strongest risk factors for HIV-related mortality were not receiving highly active antiretroviral therapy (adjusted hazard ratio 4·35, 95% CI 4·10–4·62) and having a CD4 count of less than 50 cells per μL when first declared eligible for treatment (7·92, 7·33–8.57). Interpretation An urgent need exists for earlier HIV diagnosis and better access to treatment for injecting drug users and patients infected with HIV sexually, especially before they become severely immunosuppressed. Funding The National Centre for AIDS/STD Control and Prevention of the Chinese Centre for Disease Control and Prevention.read more
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Journal ArticleDOI
Zoonotic Cryptosporidium species and Enterocytozoon bieneusi genotypes in HIV-positive patients on antiretroviral therapy
Lin Wang,Hongwei Zhang,Xudong Zhao,Longxian Zhang,Guoqing Zhang,Meijin Guo,Lili Liu,Yaoyu Feng,Lihua Xiao +8 more
TL;DR: Wang et al. as mentioned in this paper examined the distribution of Cryptosporidium species and Enterocytozoon bieneusi genotypes in AIDS patients receiving antiretroviral therapy.
Journal ArticleDOI
Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003 - 11): a national observational cohort study
Zhongwei Jia,Zhongwei Jia,Yurong Mao,Fujie Zhang,Yuhua Ruan,Ye Ma,Jian Li,Wei Guo,Enwu Liu,Zhihui Dou,Yan Zhao,Lu Wang,Qian-qian Li,Peiyan Xie,Peiyan Xie,Houlin Tang,Jing Han,Xia Jin,Juan Xu,Ran Xiong,Decai Zhao,Ping Li,Ping Li,Xia Wang,Wang Liyan,Qianqian Qing,Zhengwei Ding,Ray Y. Chen,Zhongfu Liu,Yiming Shao +29 more
TL;DR: Antiretroviral therapy for HIV-positive individuals in serodiscordant couples reduced HIV transmission across China, which suggests that the treatment-as-prevention approach is a feasible public health prevention strategy on a national scale in a developing country context.
Journal ArticleDOI
HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention.
TL;DR: It is suggested that the population-level impact of the treatment-as-prevention strategy is likely to be considerably less than as inferred from ideal conditions.
Journal ArticleDOI
Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders: The China Adherence Through Technology Study.
Lora Sabin,Mary Bachman DeSilva,Christopher J. Gill,Li Zhong,Taryn Vian,Wubin Xie,Feng Cheng,Keyi Xu,Guanghua Lan,Jessica E. Haberer,David R. Bangsberg,Yongzhen Li,Hongyan Lu,Allen L. Gifford,Allen L. Gifford +14 more
TL;DR: Real-time reminders significantly improved ART adherence in this population of Chinese HIV-infected patients and warrants further investigation and adaptation in other settings.
Journal ArticleDOI
HIV, hepatitis B virus, and hepatitis C virus co-infection in patients in the China National Free Antiretroviral Treatment Program, 2010–12: a retrospective observational cohort study
Fujie Zhang,Fujie Zhang,Hao Zhu,Yasong Wu,Zhihui Dou,Yao Zhang,Nora Kleinman,Marc Bulterys,Zunyou Wu,Ye Ma,Zhao D,Xia Liu,Hua Fang,Jing Liu,Weiping Cai,Hong Shang +15 more
TL;DR: Effective management for viral hepatitis should be integrated into HIV treatment programmes, and long-term data are needed about the effect of hepatitis co-infection on HIV disease progression.
References
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TL;DR: The early initiation of antiretroviral therapy before the CD4+ count fell below two prespecified thresholds significantly improved survival, as compared with deferred therapy.
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