[Association between antiretroviral therapy effectiveness and major chronic diseases and death among HIV-infected patients in Taizhou, Zhejiang Province, 1998-2023].

Objective

To explore the association between the effectiveness of antiretroviral therapy (ART) and major chronic diseases or death among HIV-infected patients in Taizhou, Zhejiang Province in 1998-2023.

Methods

The data were collected from Chinese Disease Prevention and Control Information System and Taizhou Chronic Disease Information Management System. The subjects were HIV-infected patients with household registration in Taizhou from 1998 to 2023, who received ART for ≥6 months and underwent viral load testing ≥2 times. Logistic regression models were used to analyze the association between ART effectiveness and major chronic diseases or death.

Results

A total of 2 918 HIV-infected patients were included, with virological suppression, low-level viremia, and virological failure accounting for 86.15% (2 514/2 918), 9.12% (266/2 918), and 4.73% (138/2 918), respectively. The incidence of major chronic diseases and case fatality rate among HIV-infected patients were 11.00% (321/2 918) and 6.58% (192/2 918), respectively. The incidence of major chronic disease in patients with virologic suppression and virological failure, as well as the fatality rate across different ART effectiveness groups, all showed an increasing trend with age (all P<0.05). After adjusting for potential confounders, compared with virologically suppressed patients, those with virological failure had a higher risk of death (aOR=2.15, 95%CI: 1.14-4.04). Age-stratified analysis revealed that in the <50 years old group, patients with low-level viremia had a higher risk of developing major chronic disease (aOR=2.15, 95%CI: 1.20-3.87).

Conclusions

The low-level viremia was associated with major chronic diseases in young and middle-aged HIV-infected patients in Taizhou, Zhejiang Province, from 1998 to 2023. For young and middle-aged HIV-infected patients with suboptimal ART responses in follow-up management, regular chronic disease screening and health management are also indicated.