| Background: In the 1990s, many HIV carriers appeared in some provinces in China, especially those in central China, owing to illegal and unregulated blood (plasma) collection and supply. Subsequently, a special group of HIV-carrying previous paid blood donors comes into being. At present, community outbreaks of AIDS and community death have occurred among this group in some provinces. Aiming at a range of serous problems probably brought to the individuals, families and the society by massive death of AIDS patients, our nation implemented the policy of "Four Exemptions and One Care" in 2003. In spite of the poor conditions of medical and health service in our country, our nation launched the Chinese-style campaign of anti-virus therapy of AIDS in rural areas. Research on the effect of anti-virus therapy for this group has never been conducted before both domestically and internationally. In view of this, we started this research.Objectives: TO investigate the mortality-rate variation tendency of paid blood donor group carrying HIV, the effect of anti-virus therapy and factors influencing the survival period of HIV carriers after implementing the policy of free anti-virus therapy in July, 2003, so as to provide scientific evidence for the later treatment, care and aid of this group.Methods: TO chose 3 counties of A province, 3 counties of B province, 1 district of C province and 1 county of D province as the study sites; chose residents of the said regions who have been detected and confirmed as HIV positive in the primary screening test conducted by WB before December 30, 2005 as the object for study. The study design shall adopt ambispective cohort study method. Cohort survival analysis method will be mainly applied in the study and software SPSS12.0 will be adopted in the analysis.Results: 1. All together 530 HIV carriers meeting the study requirements are incorporated into the study cohort. AIDS has broken out in 334 cases (63.02%) among which 147 people (27.74%) have died, 168 people (50.30%) are receiving anti-virus therapy. In the process of treatment, 19 people have died.2. During 1995-2005, the mortality rate of the study-site population fluctuated between 4-6‰. The death rate of HIV/AIDS dipped after climbing from 0 to 1.07/100, 000 in 2003. The peak value is more than 1 time less than the peak value estimated by UNAIDS Standard and delayed for 1 year. 3. With the anti-virus therapy being enhanced year by year, intension increasing from 0% in 2002 to 82.65% in 2005, the mortality rate of AIDS patients has showed a steady decreasing tendency, decreasing from 92.68/100 people to 15.68/100 people every year. 4. The mortality rate of AIDS patients without anti-virus therapy is 13.09 times (95%Cl 9.03-18.97) that of patients receiving anti-virus therapy. The therapy grade is (AR%)91.14%. 5. Compared with patients without anti-virus therapy, the survival curve of patients treated with HAART intervention is significantly delayed and the AIDS period is extended.Conclusions:①HAART constrains the peak mortality rate of HIV-carrying paid blood donor group and prevents the significant fluctuation caused by the massive death of AIDS patients.②With the HAART being enhanced year by year, the mortality of AIDS decreases year by year.③During the 3-year-long implementation period of free anti-virus therapy, the survival period of AIDS patients receiving anti-virus therapy has been extended for 2 years.④Receipt of anti-virus therapy and delay of outbreak year are major factors for extending the AIDS patients' survival period.
|
PDF Full Text Request