ABSTRACT
Objective To study the natural history of AIDS,caused by blood transfusion.Methods All HIV infections and AIDS patients were from Hebei province,including those infected through blood transfusion around 1995,that were identified as through general census of former commercial plasma donors (FCPDs).Among those objects being observed during the incubation period,354 had HIV infections( including 142 cases infected via plasmapheresis and 212 cases caused by transfusion) but had not been treated by HAART before the onset of disease.Objects being observed during the survival period,141 were AIDS patients (including 57 cases infected via plasmapheresis and 84 cases causes by transfusion) but had not been treated by HAART before and after the onset of disease.All infectors and AIDS patients were under follow-up on the progress of illness or death,respectively.Results By December 31,2010,the cumulative incidence among HIV infections was 88.70％ ( 314/354),with the incidence density as 9.14/100 person-years ( 314/3435.75 )and the median incubation period was 113 months.Of 142 HIV infections in the blood donation group and 212 infections in the blood transfusion group,the incubation periods were 112 months and 115 months,respectively.All of the 141 patients died 34 months after the onset,with the death-strength as 204.70/100 person-years (141/68.88) and the period of survival was 4 months.Among those 57 FCPDs infections,they were all died 24 months after the onset,with the death-strength as 250.66/100 person-years (57/22.74) and the survival was 3 months.The other 84 infections who were blood recipients,all died 34 months after the onset,with the death-strength as 182.05/100 person-years (84/ 46.14) and the survival was 4 months.Conclusion Through this study,we noticed that the natural history of all the AIDS patients was caused by blood transmission.It was important to evaluate the natural history of HIV epidemics among both FCPDs and blood recipients,occurred before and after 1995.
ABSTRACT
Objective To investigate the natural history of HIV infection caused by contaminated plasma donation among former commercial plasma donors in China. Methods Ambispective cohort study among HIV/AIDS cases and suspected AIDS deaths was conducted from January 1,1995 to March 31,2008 in 7 administrative villages in Shangcai county of Henan province.Information regarding diagnostic criteria, deaths and anti-retrovirus treatment was collected.Incubation and survival time were calculated using Kaplan-Meier and life-tables method. Sensitive analysis on the time of outcome was conducted. Results A total number of 2569 cases of HIV infection including 483 suspected AIDS deaths were involved in a cohort. 200 patients with rapid progress (7.8%) and 337 long-term but non-progressive patients (13.1%) were identified. Results from the sensitive analysis showed that the median incubation period from HIV infection to AIDS was between 8.5 and 8.9 years, with incidence as 11.7-12.0 cases/100 person-years and the median survival time for HIV progression to death was from 8.8 to 10.7 years, with the death rate as 6.9-8.3 cases/100 person-years. The median survival time for AIDS patient was from 1.2 to 2.0 years, with death rate as 34.9-51.5 cases/100 person-years. Conclusion According to sensitive analysis, the incubation period for HIV progression to AIDS, the median survival time for HIV progression to death and the median survival time for AIDS patient to death were 8.8 years, 1.2 years and 9.8 years,respectively.