Role of Antiviral Therapy, Co-infection, and Demographic Factors in Survival of HIV-Positive People and AIDS Patients: A Retrospective Cohort Study

Abstract

Background: Human immunodeficiency virus (HIV) infection is one of the major public health problems in the world. Objectives: The aim of this study was to identify the prognostic factors of survival time. Methods: In this retrospective cohort study, we used information from HIV-positive or acquired immune deficiency syndrome (AIDS) patients in Qazvin province from 2012 to 2021. We calculated the cumulative incidence of AIDS and deaths in HIV-positive and AIDS subjects. We examined the influence of combination antiretroviral therapy (cART), HIV transmission, co-infection with tuberculosis, history of Hepatitis B and C, and demographic factors on survival time. Using the Cox proportional hazard model, we calculated the crude and adjusted hazard ratio of disease progression to death. Results: Of 201 HIV-positive patients, 170 were identified in the first stage (n = 25) and the second stage (n = 145). The one-year, five-year, and ten-year survival rates from HIV infection to AIDS were 98%, 89%, and 71%, respectively. The survival rates from the time of HIV diagnosis to the time of death were 93%, 69%, and 43%, respectively. The hazard ratio of death from AIDS-related causes was 0.19 in patients who received antiretroviral therapy compared to those who did not (P < 0.001). Additionally, the hazard ratio was 4.11 in patients who had tuberculosis compared to those who did not (P < 0.029). Conclusions: Co-infection with tuberculosis was one of the most important prognostic factors for the progression to AIDS, and antiretroviral treatment was found to improve the survival of patients living with HIV.