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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med Chin    2010, Vol. 4 Issue (3) : 346-350     DOI: 10.1007/s11684-010-0102-x
RESEARCH ARTICLE |
Natural history of HIV infection in former plasma donors in rural China
Min ZHANG1, Hong SHANG1(), Zhe WANG2, Wei-Guo CUI2, Qing-Hai HU1
1. Key Laboratory of AIDS Immunology, Ministry of Health, the First Hospital, China Medical University, Shenyang 110001, China; 2. Center for Disease Control and Prevention of Henan Province, Zhengzhou 450016, China
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Abstract  

Patients infected through commercial blood-selling practices (former plasma donors, FPDs) in China represent a unique patient population compared to individuals infected through sexual contact or intravenous drug use. FPDs all have an approximate time of human immunodeficiency virus (HIV) infection during the mid-1990s. Few studies about the natural history of HIV infection in these patients were performed. The current study focuses on characterizing the duration of asymptomatic infection as well as the time to disease and mortality of infected FPDs in China. A retrospective cohort study was conducted based on data collected from 5484 HIV-1 infected FPDs in Shangcai county, Henan province. Kaplan-Meier analysis was applied to estimate the asymptomatic duration from the time of infection to the onset of AIDS as well as the survival period from the onset of AIDS to the time of death. The estimated median asymptomatic phase was about 9.21 years, which is similar to that reported in other developing countries in Africa. The estimated median life span after the onset of symptoms was about 9.91 months, which is notably shorter than life spans reported elsewhere. This is the first large-scale retrospective study on the natural history of HIV infection in FPDs in rural China. The findings not only provide valuable insight into an understudied population, but should also serve as an important reference for patient management and care.

Keywords human immunodeficiency virus (HIV)      former plasma donor      natural history      China     
Corresponding Authors: SHANG Hong,Email:P3lab@yeah.net   
Issue Date: 05 September 2010
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-010-0102-x     OR     http://academic.hep.com.cn/fmd/EN/Y2010/V4/I3/346
Fig.1  Survival curve of asymptomatic HIV-infected former plasma donors
itemsnpercent of total
survey location*5484100.00
 Henan province540398.52
 other provinces811.48
gender
 male259147.25
 female289352.75
age* /yr
 15-250.46
 26-147426.88
 36-217639.68
 46-146826.77
 56-3416.22
marital status*
 single2043.72
 married/cohabitating478287.20
 divorced/widowed4908.94
 unknown80.15
education level*
 unschooled77814.19
 grade school253646.24
 junior high school214339.08
 senior high school or further130.24
 unknown140.26
employment*
 farmer544299.23
 other420.77
ethnicity
 Han547299.78
 other120.22
status at cohort endpoint (Oct 1, 2006)
 progressed to AIDS, alive469185.54
 progressed to AIDS, deceased79314.46
 HAART treated4678.52
 HAART untreated3125.69
 unknown140.26
Tab.1  Demographic features of the 5484 HIV-infected former plasma donors
Fig.2  Survival curve of AIDS-stage antiretroviral-naive HIV-infected former plasma donors. ART: antiretroviral therapy.
surveillance time/yrno. of asymptomaticno. of incidenceincidence probabilitycumulative probability of survival
0-5484001
1-548410.00020.9998
2-548300.00000.9998
3-5483100.00180.9980
4-5473560.01020.9878
5-5417610.01130.9767
6-53561350.02520.9520
7-52215850.11200.8454
8-463612430.26810.6187
9-339331190.91920.0500
10-2742460.89780.0051
11-28281.00000.0000
Tab.2  Survival table of the 5484 asymptomatic HIV-infected former plasma donors
surveillance time/monthno. of AIDSno. of deathmortality probabilitycumulative probability of survival
0-312890.28530.7147
4-223360.16140.5994
8-187650.34760.3910
12-122390.31970.2660
16-83310.37350.1667
20-52190.36540.1058
24-33140.42420.0609
28-1940.21050.0481
32-1520.13330.0417
36-1350.38460.0256
40-850.62500.0096
44-310.33330.0064
48-221.00000
Tab.3  Survival table of the 312 AIDS-stage antiretroviral-naive former plasma donors
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