Individual and Joint Effects of Antiretroviral Therapy (ART) with CD4 Counts on HIV-Related Mortality of Late Diagnosis HIV/AIDS Patients: A Retrospective Cohort Study

Background: Although anti-retroviral therapy (ART) and CD4 counts before ART (CD4CBA) link to death risk of timely diagnosed HIV/AIDS patients, the role of ART and its joint effects with CD4CBA on late diagnosed HIV/AIDS participants (LDPs) remain unclear. Methods: Based on data extracted from the AIDS Prevention and Control Information System, multiple cox proportion hazardous regression models were applied to assess effects of ART and CD4CBA on the death risk of LDPs. Findings: Among 607 LDPs, the overall mortality (95% CI) for participants receiving ART was 13·48 (8·95, 18·01) per 10000 person-month and significantly lower than that of controls [468·46 (328·46, 608·46), P =120 cells/μl (median) had the lowest risk of death [AHR: 0·03; 95% CI: 0·02, 0·06; P<0·001, relative excess risk due to interaction (RERI) not significant]. Interpretation: Beyond which was attributed to ART alone, LDPs with higher CD4CBA also needed to receive ART and would obtain better efficacy. Our findings emphasize the clinical policies of LDPs administration. Funding Statement: This work was supported by Wenzhou Municipal Science and Technology Bureau public welfare science and technology plan project (Y20150294) and the student innovation program in public health and preventive medicine of the first class discipline projects (437601611). Declaration of Interests: All authors declare that they have no conflicts of interest. Ethics Approval Statement: As the data utilized for the present study were only extracted from the AIDS-PCIS and the related study protocol had been approved by institutional review boards at CCDC before the subject’s enrollment, no additional informed consent for this study was not obtained.