Analysis on the survival time and influencing factors of HIV/mycobacterium tuberculosis-coinfected patients

Objective To analyze the survival time and influencing factors of HIV/AIDS and mycobacterium tuberculosis (MTB)-coinfected patients in Chengdu, Sichuan Province. Methods Using retrospective cohort study method, through the China disease prevention and control information system of the subsystem “National AIDS Comprehensive Prevention and Control Information System”, the cases with confirmed date from January 2007 to June 2014 who lived or accepted detection/follow-up services in Chengdu were collected. All previous follow-up “tuberculosis test results” report for “extrapulmonary tuberculosis” or “tuberculosis patients” were screened”. The survival rate was calculated using the Kaplan-Meier method, and the univariate and multivariate Cox proportional hazards model were used for determining risk factors associated with survival time. Results A total of 583 HIV/MTB-coinfected patients were included in this study. 278(47.7%) and 469(80.4%) patients were found co-infected with MTB within 2 months and 12 months after HIV diagnosis. From the day of HIV/MTB co-infection reported to November 30, 2014, 141 patients died during 1 165.05 person-years of follow-up with the mortality rate of 12.10/100 person-years. In multivariate Cox analysis, HIV confirmatory age (years) (HR= 1.019, 95% CI:1.003-1.035), without ART (HR=12.278,95% CI: 7.918-19.038), the first CD4⁺T lymphocytes testing count (HR=1.712, 95% CI: 1.369-2.141) could affect the risk of all-cause mortality. Homosexual transmission (HR=0.334, 95% CI:0.166-0.672) and heterosexual transmission (HR=0.328, 95% CI: 0.137-0.781) (both compared with other transmission routes) were associated with reduced risk of HIV/MTB patients death. Conclusions HIV/AIDS cases with tuberculosis infection is mainly found in 1 year follow-up after the confirmation of HIV, the survival rate of amalgamative infection after 1 year lower than 80%. Age, non-sexually transmitted infection, not antiretroviral therapy, the low CD4⁺ T lymphocytes count of the first testing were the dominant risk factors of death in this region.