[Influencing factors on the death of HIV/AIDS patients treated with antiviral treatment in Butuo county, Liangshan Yi Autonomous Prefecture, 2010-2019].

ABSTRACT

Objective: To understand influencing factors on the deaths of HIV/AIDS patients receiving antireviral treatment in Butuo county of Liangshan Yi Autonomous Prefecture (Liangshan) from 2010 to 2019, to provide data for drug replacement and sustainable antiviral treatment strategy. Methods: A matched case-control study was used to collect basic and follow-up information on AIDS death patients receiving antiviral treatment in Butuo county of Liangshan from 2010 to 2019. The control group was formed by sampling twice the number of cases. The logistic regression model was used to analyze the risk factors affecting mortality. Results: In 3 355 patients of HIV/AIDS treated with antiviral therapy, 1 179 cases in the death group and 2 176 cases in the control group. Including 81.34% were 30-49 years old, 69.09％males, 99.55% Yi nationality, 91.12% were married or cohabitated, 95.77% had junior high school education or below, and 88.41% peasants. Amultivariate logistic stepwise regression model showed that among the death risk factors, age ≥50 years old was 5.08 times (95%CI3.05-8.48) that of the 18-29, female was 0.70 times (95%CI 0.52-0.94) than male, the transmission rate of intravenous drug use was 1.43 times (95%CI 1.06-1.91) that of heterosexual transmission, CD4+T lymphocyte (CD4) count ≥350 cells/µl before treatment was 0.38 times (95%CI 0.30-0.48) that of CD4 <200 cells/µl before treatment, the most recent antiviral treatment regimen containing LPV/r was 0.04 times (95%CI 0.01-0.18) than that of stavudine (d4T) + lamivudine (3TC) + nevirapine (NVP)/efavirenz (EFV) regimen, drug resistance was 3.40 times (95%CI 2.13-5.42) of non-drug resistance, non-viral load and non-drug resistance test results were 12.98 times (95%CI 10.28-16.40) of non-drug resistance. Conclusions: Age, gender, transmission route, CD4 before treatment, the latest antiviral treatment program, and drug resistance test after antiviral therapy were the influencing factors of HIV/AIDS death in Butuo county. It is necessary to expand the coverage of viral load and drug resistance test to change the antiviral therapeutic schedule scientifically and carry out publicity and education on the compliance of patients with antiviral treatment and medical staff training in order to reduce the mortality of patients with antiviral treatment.