Lower HIV-Related Mortality, Increased Treatment in China

But injecting drug users and sexually infected have increased mortality, less treatment coverage

THURSDAY, May 19 (HealthDay News) -- HIV-related mortality has decreased and concomitant treatment coverage has increased in China, but mortality is higher and treatment cover lower in injecting drug users and those infected sexually, according to a study published online May 19 in The Lancet Infectious Diseases.

Fujie Zhang, M.D., from the Chinese Centre for Disease Control and Prevention in Beijing, and colleagues examined the overall mortality trends in treatment-eligible adults with HIV in China and the risk factors associated with HIV-related mortality. Data, collected from the national HIV epidemiology and treatment databases, identified 145,484 individuals aged 15 years or older who were eligible for highly active antiretroviral therapy (HAART) between 1985 and 2009. Mortality rates were calculated in terms of person-years, and risk factors were identified. Treatment coverage was measured as the proportion of time that individuals who were eligible for treatment received it, and risk factors for not getting treatment were identified.

The investigators found that there was an overall decrease in mortality from 39.3 per 100 person-years in 2002 to 14.2 per 100 person-years in 2009. Treatment coverage increased during that period from almost zero to 63.4 percent. Injecting drug users and those infected sexually had higher mortality and lower treatment coverage by 2009 compared to those infected via plasma or blood donation. Not receiving HAART and having a low CD4 cell count when first declared eligible for treatment were identified as the strongest risk factors for HIV-related mortality (adjusted hazard ratio, 4.35 and 7.92, respectively).

"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," the authors write.

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