Table 2. Risk factors for death in people injecting opioids and infected with human immunodeficiency virus who received antiretroviral therapy, with or without methadone maintenance treatment, China, 2002–2011.
| Characteristic | No. (%) of participantsa | No. (%) of deaths | Person–years of observation | Mortality rateb (95% CI) | Multivariate analysisc |
|
|---|---|---|---|---|---|---|
| Unadjusted HR (95% CI) | Adjusted HR (95% CI) | |||||
| Demographic characteristic | ||||||
| Age, years | ||||||
| 15–29 | 4 574 (19.2) | 507 (16.6) | 8 857 | 5.7 (5.2–6.2) | 1.0 | 1.0 |
| 30–39 | 14 265 (59.9) | 1 913 (62.6) | 25 836 | 7.4 (7.1–7.7) | 1.3 (1.1–1.4) | 1.4 (1.2–1.6) |
| ≥ 40 | 4 974 (20.9) | 637 (20.8) | 7 267 | 8.8 (8.1–9.4) | 1.4 (1.2–1.6) | 1.6 (1.4–1.9) |
| Gender | ||||||
| Male | 20 868 (87.6) | 2 777 (90.8) | 36 497 | 7.6 (7.3–7.9) | 1.5 (1.3–1.7) | 1.8 (1.6–2.1) |
| Female | 2 945 (12.4) | 280 (9.2) | 5 463 | 5.1 (4.5–5.7) | 1.0 | 1.0 |
| Ethnicity | ||||||
| Han Chinese | 12 892 (61.3) | 1 620 (69.1) | 24 927 | 6.5 (6.2–6.8) | 1.2 (1.1–1.3) | 1.0 (0.9–1.1) |
| Other | 8 126 (38.7) | 726 (30.9) | 12 504 | 5.8 (5.4–6.2) | 1.0 | 1.0 |
| Educational leveld | ||||||
| Primary school or lower | 8 154 (39.6) | 782 (34.2) | 12 062 | 6.5 (6.0–6.9) | 1.0 | NA |
| Middle school or higher | 12 416 (60.4) | 1 503 (65.8) | 24 210 | 6.2 (5.9–6.5) | 1.0 (0.9–1.1) | NA |
| Marital status | ||||||
| Single, divorced or widowed | 10 796 (45.6) | 1 625 (53.3) | 19 404 | 8.4 (8.0–8.8) | 1.3 (1.2–1.4) | 1.5 (1.3–1.6) |
| Married or cohabiting | 12 876 (54.4) | 1 421 (46.7) | 22 398 | 6.3 (6.0–6.7) | 1.0 | 1.0 |
| Clinical characteristic at ART initiation | ||||||
| CD4+ cell count (cells/µL) | ||||||
| < 50 | 3 927 (17.0) | 967 (32.5) | 8 067 | 12.0 (11.2–12.7) | 2.8 (2.5–3.0) | 1.8 (1.5–2.0) |
| 50–200 | 9 265 (40.1) | 1 302 (43.7) | 18 490 | 7.0 (6.7–7.4) | 1.6 (1.4–1.7) | 1.4 (1.2–1.5) |
| > 200 | 9 907 (42.9) | 709 (23.8) | 14 729 | 4.8 (4.5–5.2) | 1.0 | 1.0 |
| Haemoglobin concentration (g/dL) | ||||||
| < 9 | 1 515 (6.8) | 452 (16.1) | 2 577 | 17.5 (15.9–19.2) | 3.6 (3.2–4.0) | 3.2 (2.8–3.7) |
| 9–12 | 5 131 (23.2) | 999 (35.7) | 9 491 | 10.5 (9.9–11.2) | 2.2 (2.0–2.4) | 2.1 (1.9–2.3) |
| > 12 | 15 485 (70.0) | 1 351 (48.2) | 27 569 | 4.9 (4.6–5.2) | 1.0 | 1.0 |
| ART | ||||||
| Treatment regimen | ||||||
| Zidovudine, lamivudine and nevirapine/efavirenz | 11 495 (55.4) | 1 097 (41.3) | 16 146 | 6.8 (6.4–7.2) | 1.0 | 1.0 |
| Stavudine, lamivudine and nevirapine/efavirenz | 9 271 (44.6) | 1 560 (58.7) | 20 766 | 7.5 (7.1–7.9) | 1.3 (1.2–1.4) | 0.9 (0.8–1.0) |
| Treatment facility | ||||||
| Infectious disease hospital | 3 739 (16.8) | 448 (15.2) | 7 698 | 5.8 (5.3–6.4) | 1.0 | 1.0 |
| General hospital | 15 237 (68.4) | 1 908 (64.6) | 25 777 | 7.4 (7.1–7.7) | 1.2 (1.1–1.3) | 2.2 (1.9–2.5) |
| CDC clinic | 3 290 (14.8) | 598 (20.2) | 6 138 | 9.7 (9.0–10.5) | 1.6 (1.4–1.9) | 3.0 (2.5–3.6) |
| Study subgroup | ||||||
| MMT programme participation | ||||||
| No (ART-only subgroup) | 18 652 (78.3) | 2 519 (82.4) | 30 558 | 8.2 (7.9–8.6) | 1.6 (1.5–1.8) | 1.4 (1.3–1.6) |
| Yes (ART + MMT subgroup) | 5 161 (21.7) | 538 (17.6) | 11 401 | 4.7 (4.3–5.1) | 1.0 | 1.0 |
| Total | 28 813 (100.0) | 3 057 (100.0) | 41 959 | 7.3 (7.0–7.5) | NA | NA |
ART, antiretroviral therapy; CDC, Center for Disease Control and Prevention; CI: confidence interval; HR: hazard ratio; MMT, methadone maintenance treatment; NA, not applicable.
a The analyses involved only study participants for whom complete data were available.
b Per 100 person–years.
c Cox proportional hazards regression analysis.
d Some variables were not included in the regression analysis and, consequently, no results are presented for them. 95% CIs were calculated on assumption of a Poisson distribution.