Immunological failure of antiretroviral therapy of HIV/AIDS patients in Guigang city from 2006 to 2021 and its influencing factors

Objective: To analyze the immunological failure of antiretroviral therapy (ART) of HIV/AIDS patients in Guigang city from 2006 to 2021 and its influencing factors.Methods: The data of HIV/AIDS patients who received ART in Guigang city from 2006 to 2021 were collected from the National Free AIDS Prevention and Control Information System.The life table method was used to describe the overall immunological failure of the subjects.Multivariate COX regression model was used to analyze the influencing factors of immunological failure.Results: A total of 6, 903 HIV/AIDS patients were included in this study, of whom 4, 314 (61.28%) suffered ART immunological failure.The cumulative incidence of immunological failure was 57.9%、67.3% and 68.6% in the 1st, 5th and 10th year, respectively.Patients infected with HIV, with the baseline CD4⁺T cell count 200-350 cells/μL and ＞ 350 cells/μL (referenced to ＜ 200 cells/μL, HR=1.098, 95% CI=1.011-1.192, P=0.027 and HR=1.112, 95% CI=1.001-1.236, P=0.048), baseline WHO clinical stage at Ⅲ (referenced to stage Ⅰ, HR=1.156, 95%CI=1.058-1.263, P=0.001), and using AZT+3TC+NVP regimen (referenced to TDF+3TC+EFV, HR=1.538, 95% CI=1.394-1.696, P＜ 0.001) had a higher risk of immunological failure.Conclusion: The immunological failure rate of ART patients in Guigang city is relatively high, and the influencing factors are complex.Targeted clinical management measures should be taken for the patients with different characteristics.The ART effect of HIV/AIDS patients in Guigang city can be improved by strengthening the monitoring of CD4⁺T cell level and timely adjusting the ART regimens, etc.