• Qian Zhu, Liming Wang, Wen Lin, Marc Bulterys, Wenjie Yang, Dingyong Sun, Zhaolin Cui, Jonathan Kaplan, Nora Kleinman, Xiaoyu Wei, Jessica Chung, and Zhe Wang.
• Henan Provincial Center for Disease Control and Prevention, No.105 Nongye South Road, New District Zhengdong, Zhengzhou Prefecture, Henan Province 450016, China. zhe.1.wang@outlook.com.
• Curr. HIV Res. 2014 Jan 1; 12 (5): 359-65.

ObjectivesThis study aims to evaluate the effect of co-trimoxazole (CTX) prophylaxis on mortality reduction among HIV-infected patients receiving antiretroviral therapy (ART) in Henan Province, China.DesignWe conducted a retrospective study.MethodsAll individuals aged 15 years and older who initiated ART between 2008 and 2010 in Henan Province with completed CTX prophylaxis treatment information were included. The effect of CTX prophylaxis was estimated using Kaplan-Meier survival analysis and multivariate Cox proportional hazard modeling for mortality at 3-months and 12-months after ART initiation.ResultsOverall mortality among patients receiving both ART and CTX was nearly double at 3-months after ART initiation compared with that at 12-months (12.4 per 100 PY vs 6.3 per 100 PY, p < 0.01). After adjusting for gender, age, TB history, year of ART initiation and CD4 count at ART initiation, CTX was associated with a significant reduction in 12-month mortality (adjusted hazard ratio (AHR) = 0.65, 95% confidence interval (CI): 0.44-0.95; p = 0.027) compared with persons not receiving CTX. The protective effect was more pronounced in the first 3 months after ART initiation (AHR = 0.53, 95% CI: 0.32-0.89; p = 0.017).ConclusionCTX prophylaxis together with ART reduced mortality of adult HIV patients during the first 12 months of ART in Henan Province, China. The effect was highest in the first 3 months of ART. CTX should be prescribed to all HIV-infected adults who initiate ART.

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