{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T11:27:38Z","timestamp":1761391658561,"version":"build-2065373602"},"reference-count":60,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2016,3,8]],"date-time":"2016-03-08T00:00:00Z","timestamp":1457395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study assesses association between CD4 level at initiation of antiretroviral treatment (ART) on subsequent treatment outcomes and mortality among people infected with HIV via various routes in Hunan province, China. Over a period of 10 years, a total of 7333 HIV-positive patients, including 553 (7.5%) MSM, 5484 (74.8%) heterosexuals, 1164 (15.9%) injection drug users (IDU) and 132 (1.8%) former plasma donors (FPD), were recruited. MSM substantially demonstrated higher initial CD4 cell level (242, IQR 167\u2013298) than other populations (Heterosexuals: 144 IQR 40\u2013242, IDU: 134 IQR 38\u2013224, FPD: 86 IQR 36\u2013181). During subsequent long-term follow up, the median CD4 level in all participants increased significantly from 151 cells\/mm3 (IQR 43\u2013246) to 265 cells\/mm3 (IQR 162\u2013380), whereas CD4 level in MSM remained at a high level between 242 and 361 cells\/mm3. Consistently, both cumulative immunological and virological failure rates (10.4% and 26.4% in 48 months, respectively) were the lowest in MSM compared with other population groups. Survival analysis indicated that initial CD4 counts \u2264200 cells\/mm3 (AHR = 3.14; CI, 2.43\u20134.06) significantly contributed to HIV-related mortality during treatment. Timely diagnosis and treatment of HIV patients are vital for improving CD4 level and health outcomes.<\/jats:p>","DOI":"10.3390\/ijerph13030283","type":"journal-article","created":{"date-parts":[[2016,3,8]],"date-time":"2016-03-08T10:14:25Z","timestamp":1457432065000},"page":"283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Superior Effects of Antiretroviral Treatment among Men Who have Sex with Men Compared to Other HIV At-Risk Populations in a Large Cohort Study in Hunan, China"],"prefix":"10.3390","volume":"13","author":[{"given":"Shu","family":"Su","sequence":"first","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3004, Australia"},{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Mao","sequence":"additional","affiliation":[{"name":"Center for Social Research in Health, Faculty of Arts and Social Science at the University of New South Wales, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianmei","family":"He","sequence":"additional","affiliation":[{"name":"Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuqing","family":"Wei","sequence":"additional","affiliation":[{"name":"Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Jing","sequence":"additional","affiliation":[{"name":"Comprehensive AIDS Research Center, Tsinghua University, Beijing 100084, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3004, Australia"},{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia"},{"name":"Comprehensive AIDS Research Center, Tsinghua University, Beijing 100084, China"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1001\/jama.2010.1004","article-title":"Antiretroviral treatment of adult HIV infection: 2010 Recommendations of the international AIDS society-USA panel","volume":"304","author":"Thompson","year":"2010","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1056\/NEJM199709113371101","article-title":"A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency vs. infection and CD4 cell counts of 200 per cubic millimeter or less. 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