Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China
Abstract Background The proportion of people living with HIV (PLHIV) in Guangxi who are men who have sex with men (MSM) increased rapidly to nearly 10% in 2023; notably, over 95% of this particular population is currently receiving antiretroviral therapy (ART). This study aimed to describe the survi...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-025-10531-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571971658842112 |
|---|---|
| author | Huaxiang Lu Huanhuan Chen Shujia Liang Yuhua Ruan He Jiang Jinghua Huang Guangjie Tan Xiuling Wu Jianjun Li Chen Gong Qiuying Zhu Guanghua Lan |
| author_facet | Huaxiang Lu Huanhuan Chen Shujia Liang Yuhua Ruan He Jiang Jinghua Huang Guangjie Tan Xiuling Wu Jianjun Li Chen Gong Qiuying Zhu Guanghua Lan |
| author_sort | Huaxiang Lu |
| collection | DOAJ |
| description | Abstract Background The proportion of people living with HIV (PLHIV) in Guangxi who are men who have sex with men (MSM) increased rapidly to nearly 10% in 2023; notably, over 95% of this particular population is currently receiving antiretroviral therapy (ART). This study aimed to describe the survival of MSM PLHIV, depict the characteristics and trends of changes in CD4+ T cell counts, CD4+/CD8+ T cell ratio, and viral load, and explore immunological indicators that may be related to mortality during different stages of treatment. Methods Immunological indicators of MSM PLHIV receiving ART were extracted and categorized into baseline, mid-treatment, and last values. These were then incorporated into the Cox models in the form of repeated measurements to evaluate the associations (Adjusted-hazard ratios, aHRs) and 95% confidence intervals (95% CIs) of these immunological indicators with mortality at different stages. Results A total of 5,642 patients who met the criteria were enrolled in the study, and 160 died, representing a mortality of 2.8%. The first, median, and last values of the CD4+ count and the CD4+/CD8+ ratio in surviving patients were significantly greater than the corresponding values in nonsurviving patients (P < 0.001). Except for the first viral load (P = 0.379), the median and last viral loads of the former were significantly lower than those of the latter (P < 0.001). In Cox model, with 2,144 cases, immunological indicators of increased mortality risk included a baseline CD4+ count below 200 cells/µL (aHR: 4.58, 95% CI: 2.28–9.19), a median (aHR: 8.46, 95% CI: 3.05–23.46), and a final (aHR: 4.43, 95% CI: 1.06–18.45) ratio below 0.7 and a median (aHR: 9.47, 95% CI: 4.02–22.35) and final (aHR: 14.46, 95% CI: 4.50–46.50) viral load 100,000 copies/mL and above. Conclusions Mortality among MSM PLHIV on ART in Guangxi is relatively low, and both high viral loads and low CD4+/CD8+ T cell ratios during treatment and at recent follow-up are strongly predictive of a serious prognosis and should be closely monitored. |
| format | Article |
| id | doaj-art-fe230b3855f848899fe6525236d253c0 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-fe230b3855f848899fe6525236d253c02025-02-02T12:10:47ZengBMCBMC Infectious Diseases1471-23342025-01-0125111610.1186/s12879-025-10531-3Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern ChinaHuaxiang Lu0Huanhuan Chen1Shujia Liang2Yuhua Ruan3He Jiang4Jinghua Huang5Guangjie Tan6Xiuling Wu7Jianjun Li8Chen Gong9Qiuying Zhu10Guanghua Lan11Guangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlChinese Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlGuangxi Zhuang Autonomous Region Center for Disease Prevention and ControlAbstract Background The proportion of people living with HIV (PLHIV) in Guangxi who are men who have sex with men (MSM) increased rapidly to nearly 10% in 2023; notably, over 95% of this particular population is currently receiving antiretroviral therapy (ART). This study aimed to describe the survival of MSM PLHIV, depict the characteristics and trends of changes in CD4+ T cell counts, CD4+/CD8+ T cell ratio, and viral load, and explore immunological indicators that may be related to mortality during different stages of treatment. Methods Immunological indicators of MSM PLHIV receiving ART were extracted and categorized into baseline, mid-treatment, and last values. These were then incorporated into the Cox models in the form of repeated measurements to evaluate the associations (Adjusted-hazard ratios, aHRs) and 95% confidence intervals (95% CIs) of these immunological indicators with mortality at different stages. Results A total of 5,642 patients who met the criteria were enrolled in the study, and 160 died, representing a mortality of 2.8%. The first, median, and last values of the CD4+ count and the CD4+/CD8+ ratio in surviving patients were significantly greater than the corresponding values in nonsurviving patients (P < 0.001). Except for the first viral load (P = 0.379), the median and last viral loads of the former were significantly lower than those of the latter (P < 0.001). In Cox model, with 2,144 cases, immunological indicators of increased mortality risk included a baseline CD4+ count below 200 cells/µL (aHR: 4.58, 95% CI: 2.28–9.19), a median (aHR: 8.46, 95% CI: 3.05–23.46), and a final (aHR: 4.43, 95% CI: 1.06–18.45) ratio below 0.7 and a median (aHR: 9.47, 95% CI: 4.02–22.35) and final (aHR: 14.46, 95% CI: 4.50–46.50) viral load 100,000 copies/mL and above. Conclusions Mortality among MSM PLHIV on ART in Guangxi is relatively low, and both high viral loads and low CD4+/CD8+ T cell ratios during treatment and at recent follow-up are strongly predictive of a serious prognosis and should be closely monitored.https://doi.org/10.1186/s12879-025-10531-3HIVViral loadCD4+ T cellCD4+/CD8+ T cell ratioHomosexualMSM |
| spellingShingle | Huaxiang Lu Huanhuan Chen Shujia Liang Yuhua Ruan He Jiang Jinghua Huang Guangjie Tan Xiuling Wu Jianjun Li Chen Gong Qiuying Zhu Guanghua Lan Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China BMC Infectious Diseases HIV Viral load CD4+ T cell CD4+/CD8+ T cell ratio Homosexual MSM |
| title | Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China |
| title_full | Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China |
| title_fullStr | Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China |
| title_full_unstemmed | Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China |
| title_short | Mortality and immunological indicators of men who have sex with men living with HIV on antiretroviral therapy: a 10-year retrospective cohort study in Southern China |
| title_sort | mortality and immunological indicators of men who have sex with men living with hiv on antiretroviral therapy a 10 year retrospective cohort study in southern china |
| topic | HIV Viral load CD4+ T cell CD4+/CD8+ T cell ratio Homosexual MSM |
| url | https://doi.org/10.1186/s12879-025-10531-3 |
| work_keys_str_mv | AT huaxianglu mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT huanhuanchen mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT shujialiang mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT yuhuaruan mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT hejiang mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT jinghuahuang mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT guangjietan mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT xiulingwu mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT jianjunli mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT chengong mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT qiuyingzhu mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina AT guanghualan mortalityandimmunologicalindicatorsofmenwhohavesexwithmenlivingwithhivonantiretroviraltherapya10yearretrospectivecohortstudyinsouthernchina |