[Analysis of factors influencing AIDS-related deaths among HIV-infected people in Shandong Province, 2017-2021].

Objective: To explore the influencing factors of AIDS-related deaths among HIV-infected patients in Shandong Province, to help reduce the risk of death and prolong survival time. Methods: The study population was HIV-infected patients in Shandong Province from 2017-2021, and Cox proportional hazards regression model was used to analyze the influencing factors of AIDS-related deaths and deaths within one year of confirmation. Results: Among 14 700 HIV- infected patients reported in Shandong Province in 2017-2021, 351 AIDS-related deaths occurred, accounting for 2.4% (351/14 700). The results of multifactorial Cox proportional hazards regression model analysis showed that the risk factors for AIDS-related deaths among HIV-infected patients included education level of junior high school, high school, and secondary school (a HR =1.37, 95% CI :1.01-1.84), sample source from healthcare institutions (a HR =1.61, 95% CI :1.22-2.12), duration of disease in AIDS stage (a HR =9.86,95% CI :6.86-14.19), baseline CD4 ⁺ T lymphocytes (CD4) undetected (a HR =3.93, 95% CI :2.69-5.75), duration of antiviral treatment (ART) <6 months (a HR =3.46, 95% CI :2.42-4.93) and no ART (a HR =1.45, 95% CI :1.02-2.07), final CD4 <200 cells/μl (a HR =3.51, 95% CI :2.18-5.65) and final CD4 undetected (a HR =10.58, 95% CI :6.15-18.19), and final viral load (VL) values of 50-999 copies/ml,≥1 000 copies/ml and undetected (a HR =2.59, 95% CI :1.07-6.26; a HR =9.50, 95% CI :5.60-16.12; a HR =15.33, 95% CI :8.91-26.36). Factors with higher risk of AIDS-related deaths within one year of confirmation of HIV-infected patients included samples originating from healthcare facilities (a HR =1.68, 95% CI : 1.19-2.36), AIDS stage of disease (a HR =10.60, 95% CI :7.13-15.75), baseline CD4 undetected (a HR =3.71, 95% CI :2.34-5.90), duration of ART <6 months (a HR =4.30, 95% CI :2.85-6.49) and no ART (a HR =2.05, 95% CI :1.35-3.13), final CD4 <200 cells/μl (a HR =5.45,95% CI :2.04-14.60) and final CD4 undetected (a HR =20.95, 95% CI : 7.69- 57.04), and final VL values of 50-999 copies/ml, ≥1 000 copies/ml and undetected (a HR =15.21, 95% CI : 2.54-91.21; a HR =42.93, 95% CI :9.64-191.20; a HR =61.35, 95% CI :13.85-271.77). Conclusions: Expanding the coverage of testing, promoting early detection and treatment, strengthening regular follow-up and the test of HIV-infected patients, grasping the progress of the disease to provide accurate management and treatment are important for reducing the disease mortality rate and prolonging the survival time of HIV-infected patients.