%0 Journal Article
%T Mortality Risk Factors Among People Living with HIV Receiving Second-line Antiretroviral Therapy in Rural China.
%A Kang Q
%A Pan W
%A Ma Y
%A Wang D
%A Jia H
%A Guo H
%A Sang F
%A Xu L
%A Xu Q
%A Jin Y
%J Curr HIV Res
%V 22
%N 2
%D 2024 Jan 19
%M 38310467
%F 1.341
%R 10.2174/011570162X280721240108065502
%X <B>BACKGROUND: </B>Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing.<BR><B>OBJECTIVE: </B>This study aimed to investigate the survival and factors affecting mortality among this group.<BR><B>METHODS: </B>We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan-Meier method and Cox proportional hazards models.<BR><B>RESULTS: </B>We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55-0.79), > 50 years old (HR, 2.69; 95% CI, 2.03-3.56), single/widowed (HR, 1.26; 95% CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52-0.96), liver injury (HR, 1.58; 95% CI, 1.19-2.10), and CD4+ T cell count <200 cells/μl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/μl (HR, 1.37; 95% CI, 1.03-1.82) were associated with mortality risk.<BR><B>CONCLUSIONS: </B>We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.