Associations of modern initial antiretroviral therapy regimens with all-cause mortality in people living with HIV in resource-limited settings: a retrospective multicenter cohort study in China

Xinsheng Wu, Guohui Wu, Ping Ma, Rugang Wang, Linghua Li, Yuanyi Chen, Junjie Xu, Yuwei Li, Quanmin Li, Yuecheng Yang, Lijing Wang, Xiaoli Xin, Ying Qiao, Gengfeng Fu (), Xiaojie Huang (), Bin Su (), Tong Zhang (), Hui Wang () and Huachun Zou ()
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Xinsheng Wu: Shenzhen Campus of Sun Yat-sen University
Guohui Wu: Chongqing Center for Disease Control and Prevention
Ping Ma: Tianjin Second People’s Hospital
Rugang Wang: Dalian Public Health Clinical Center
Linghua Li: Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University
Yuanyi Chen: Shenzhen Campus of Sun Yat-sen University
Junjie Xu: Peking University Shenzhen Hospital, Peking University
Yuwei Li: Shenzhen Campus of Sun Yat-sen University
Quanmin Li: Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University
Yuecheng Yang: Dehong Prefecture Center for Disease Control and Prevention
Lijing Wang: Shijiazhuang Fifth Hospital
Xiaoli Xin: No.6 People’s Hospital of Shenyang
Ying Qiao: No.2 Hospital of Hohhot
Gengfeng Fu: Jiangsu Provincial Center for Disease Control and Prevention
Xiaojie Huang: Beijing Youan Hospital, Capital Medical University
Bin Su: Beijing Youan Hospital, Capital Medical University
Tong Zhang: Beijing Youan Hospital, Capital Medical University
Hui Wang: The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology
Huachun Zou: Fudan University

Nature Communications, 2023, vol. 14, issue 1, 1-10

Abstract: Abstract Despite the proven virological advantages, there remains some controversy regarding whether first-line integrase strand transfer inhibitors (INSTIs)-based antiretroviral therapy (ART) contributes to reducing mortality of people living with HIV (PLHIV) in clinical practice. Here we report a retrospective study comparing all-cause mortality among PLHIV in China who were on different initial ART regimens (nevirapine, efavirenz, dolutegravir, lopinavir, and others [including darunavir, raltegravie, elvitegravir and rilpivirine]) between 2017 and 2019. A total of 41,018 individuals were included across China, representing 21.3% of newly reported HIV/AIDS cases collectively in the country during this period. Only the differences in all-cause mortality of PLHIV between the efavirenz group and the nevirapine group, the dolutegravir group and the nevirapine group, and the lopinavir group and the nevirapine group, were observed in China. After stratifying the cause of mortality, we found that the differences in mortality between initial ART regimens were mainly observed in AIDS-related mortality.

Date: 2023
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DOI: 10.1038/s41467-023-41051-w

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