Associated factors for progression to AIDS among HIV-infected people who use drugs: a retrospective cohort study in Dongguan, China

OBJECTIVES: Injection drug use is the most important risk factor for the spread of HIV in China over the past two decades. People who use drugs (PWUD) who were diagnosed at an early stage with HIV have gradually developed AIDS. This study investigated the factors associated with disease progression following HIV diagnosis in PWUD. DESIGN: This study used a retrospective cohort study. SETTING: This investigation was conducted in Dongguan city, Guangdong Province, China. PARTICIPANTS: A total of 2969 PWUD with HIV were recruited from 1 January 1995 to 31 December 2014. PRIMARY AND SECONDARY OUTCOME MEASURES: Kaplan-Meier method, Logistic regression and Cox proportional hazards regression model were applied to identify the related factors of progression to AIDS following HIV diagnosis. RESULTS: The study revealed that age at diagnosis, marital status, baseline CD4 T-cell counts and highly active antiretroviral therapy (HAART) were statistically significant (p<0.01), either in the patients with HIV or in patients with AIDS. Compared with HIV-infected individuals of 18 years, patients with AIDS who were at least 36 years of age possessed sharply increased HR for developing AIDS (HR=7.016, 95% CI 6.083 to 8.092, p=0.001). The single HIV-positive individuals (HR=0.691, 95% CI 0.588 to 0.811, p=0.001) were less likely to develop AIDS compared with married ones. Increasing baseline CD4 T-cell counts, HAART (HR=0.599, 95% CI 0.517 to 0.693, p=0.001) and condom usage (HR=0.825, 95% CI 0.710 to 0.959, p=0.012) were associated with delayed progression to AIDS. CONCLUSIONS: Our study found that increasing baseline CD4 T-cell counts, HAART and condom usage might be associated with delayed the progression of HIV to AIDS, while increasing age at diagnosis, marital status increased hazard for developing AIDS.