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J Res Med Sci. 2019 Jan 31;24:5. doi: 10.4103/jrms.JRMS_630_18. eCollection 2019.

Survival and associated factors among people living with HIV/AIDS: A 30-year national survey in Iran.

Author information

1
Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
2
Department of Epidemiology and Biostatistics, Public Health School, Kerman University of Medical Sciences, Kerman, Iran.
3
National Communicable Disease Control Centre, Ministry of Health and Medical Education, Tehran, Iran.
4
HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Background:

The survival in Iranian HIV/AIDS patients based on data from Iran National HIV/AIDS Case Registry System has not been evaluated. This study assessed the survival rates and associated factors among people living with HIV/AIDS in Iran.

Materials and Methods:

The population in this observational study included 32168 patients diagnosed with HIV/AIDS registered in Iran disease registry system between 1986 and 31 December 2015. Data until June 2016 (the cutoff date of our last data linkage) were investigated to estimate survival and related factors following HIV diagnosis.

Results:

Of registered patients, 17.7% were diagnosed at AIDS stage. By June 2016, 27.2% of study population progressed to AIDS, and 8081 (25.1%) of patients died. The survival rate was 88%, 85%, 77%, and 67% for 1, 2, 5, and 10 years, respectively. Cumulative proportion surviving was significantly lower in males than in females (P = 0.0001). A higher rate of survival was seen in female patients, who diagnosed after 2010, infected in sexual route, and had CD4 cell count more than 500, nonconfected patients with tuberculosis (TB), and those who received antiretroviral therapy (ART). Based on multivariate model, the mortality risk in female patients, those with CD4 cell count more than 500, patients who received ART, and those with TB and injection drug uses (IDUs) was higher.

Conclusion:

The survival in studied patients increased in recent time periods, and ART reduced AIDS-related mortality in these patients. The survival can be increased by focus on improvements in patient care among male patients, IDUs, and patients with TB coinfection.

KEYWORDS:

Antiretroviral therapy; HIV/AIDS; Iran; survival

Conflict of interest statement

Dr. Ali-Akbar Haghdoost is the head Deputy of Strategic Planning and Coordination at Iran Ministry of Health and Medical Education, Dr. Mohammad-Mehdi Gooya is the Director General and Head of Center for Communicable Disease Control of the Ministry of Health, and Dr. Parvin Afsar-Kazerooni is the head of the National HIV/AIDS Control Committee.

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