초록 열기/닫기 버튼
Purpose: In the recent antiretroviral therapy (ART) era, a large proportion of Korean patients with human immunodeficiency virus(HIV) infection were shown to have low CD4 cell counts at diagnosis and during ART initiation. We investigated the survivaltrends in patients living with HIV/acquired immunodeficiency syndrome (AIDS) in Korea who started ART in the 2000s, andevaluated the risk factors for mortality to elucidate the association between survival and low CD4 cell counts at ART initiation. Materials and Methods: Patients with HIV infection who were aged >18 years and had started ART between 2001 and 2015 in theKorean HIV/AIDS cohort study were enrolled. We compared the clinical characteristics, mortality, and causes of death amongthe enrolled subjects based on the time of ART initiation. Cox regression analysis was used to estimate the adjusted hazard ratiosof mortality based on the time of ART initiation. Results: Among the 2474 patients enrolled, 105 (4.24%) died during the follow-up period of 9568 patient-years. Although CD4 cellcounts at the time of ART initiation significantly increased from 161 [interquartile range (IQR), 73.5–303] in 2001–2003 to 273 (IQR,108–399) in 2013–2015 (p<0.001), they remained low during the study period. The incidence of all-cause mortality was 10.97 per1000 patient-years during the study period. There was no decreasing trend in mortality between 2001 and 2015. Age >40 years [adjustedhazard ratio, 3.71; 95% confidence interval (CI), 2.35–5.84] and low CD4 counts (<100 cells/mm3: adjusted hazard ratio,2.99; 95% CI, 1.44–6.23) were significant risk factors for mortality. Conclusion: Despite excellent HIV care available in the recent ART era, the survival of patients with HIV/AIDS undergoing ARTdid not improve between 2001 and 2015 in Korea.
