Efficacy and survival analysis after antiretroviral therapy among HIV-infected adolescents through sexual transmission, 2011-2015

Objective To understand the effect and survival status after antiretroviral therapy (ART) among HIV-infected adolescents through sexual transmission, and analyze their related risk factors. Methods From 2011 to 2015, a total of 2 765 HIV-infected adolescentst hrough sexual transmission across China received ART, whose baseline and follow-up data were collected and used for the retrospective analysis of their viral suppression and survival status, as well as the risk factors related to the two outcomes. Results Among 2 451 patients who had viral load tests of 2 765 cases, viral suppression rate reached 90.06%. Forty-seven patients died, of which the median survival time from ART initiation was 6.8 months (QR: 3.4-14.5 months) . Multivariate logistic regression analysis revealed that the viral failure was associated with lower age (15 years old, OR=2.218, 95%CI: 1.229-4.004) at ART initiation, heterosexually-transmitted female (OR=1.557, 95%CI: 1.093-2.219) , baseline CD4+T cell count<200/μL (OR=2.413, 95%CI: 1.569-3.709) and non-tenofovir-based initial regimens (OR=1.460, 95%CI: 1.066-1.998) . The cox model showed that heterosexually-transmitted female (adjusted HR=2.259, 95%CI: 1.181-4.319) , baseline WHO clinical stage Ⅳ (adjusted HR=2.933, 95%CI: 1.446-5.950) , baseline CD4+T cell count<200/μL (adjusted HR=9.865, 95%CI: 3.694-26.348) were the risk factors for death in adolescents with sexually-transmitted HIV. Conclusions Early detection and treatment of adolescents with HIV infection, more focus on younger, heterosexually-transmitted female, and optimized treatment regimen are recommended for the reduction of the risk of both death and HIV transmission. Key words: HIV/AIDS; Viral suppression; Survival analysis; CD4+ T lymphocytes