Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system

Zhenqiu Liu; Oumin Shi; Qiong Yan; Qiwen Fang; Jialu Zuo; Yue Chen; Xingdong Chen; Tiejun Zhang

doi:10.1186/s12879-018-3551-5

Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system

BMC Infect Dis. 2018 Dec 27;18(1):700. doi: 10.1186/s12879-018-3551-5.

Authors

Zhenqiu Liu^{1

2

3

4}, Oumin Shi⁵, Qiong Yan⁶, Qiwen Fang^{2

3}, Jialu Zuo^{2

3}, Yue Chen⁷, Xingdong Chen^{8

9

10}, Tiejun Zhang^{11

12}

Affiliations

¹ State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200032, China.
² Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
³ Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China.
⁴ Fudan University Taizhou Institute of Health Sciences, Taizhou, China.
⁵ Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen, China.
⁶ Department of Child and Maternal Health, School of Public Health, Fudan University, Shanghai, China.
⁷ School of Epidemiology and Public Health Faculty of Medicine, University of Ottawa, Ottawa, Canada.
⁸ State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200032, China. xingdongchen@fudan.edu.cn.
⁹ Fudan University Taizhou Institute of Health Sciences, Taizhou, China. xingdongchen@fudan.edu.cn.
¹⁰ Human Phenome Institute, Fudan University, 825 Zhangheng Road, Shanghai, 201203, China. xingdongchen@fudan.edu.cn.
¹¹ Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. tjzhang@shmu.edu.cn.
¹² Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China. tjzhang@shmu.edu.cn.

Abstract

Background: China has made substantial progress in tackling its HIV and AIDS epidemic. But the changing patterns of HIV and AIDS incidence based on the longitudinal observation data were rarely studied.

Methods: The reporting incidence (RI) and mortality data on HIV and AIDS in China covering 31 provinces from 2004 to 2014 were collected from the Chinese Public Health Science Data Center. To decompose the time-series data, Empirical Mode Decomposition (EMD) was applied to properly describe the trends of HIV and AIDS incidence. A mathematical model was used to estimate the relative change of incidence among provinces and age groups.

Results: A total of 483,010 newly HIV infections and 214,205 AIDS cases were reported between 2004 and 2014 nationwide. HIV infection increased from 13,258 in 2004 (RI 1.02 per 100,000 person years) to 74,048 in 2014 (RI 5.46 per 100,000). The number of AIDS cases increased from 3054 in 2004 (RI 0.23 per 100,000) to 45,145 in 2014 (RI 3.33 per 100,000). The overall relative changes for HIV infection and AIDS incidence were 1.11 (95% confidence interval [CI] 1.10-1.13) and 1.28 (95% CI 1.23-1.33), respectively. The relative increase for HIV and AIDS RI was higher in northwest provinces while lower in Henan, Xinjiang, Guangxi and Yunnan. The overall relative changes for HIV infection were 1.12 (95% CI 1.11-1.14) in males and 1.10 (95% CI 1.06-1.13) in females. For AIDS RI, the relative increases were 1.31 (95% CI 1.26-1.36) in males and 1.22 (95% CI 1.17-1.28) in females. The lowest relative increase was detected among young adults, while the largest relative increase (odds ratio [OR] > 1.30) was detected in people aged 55 years or above.

Conclusions: HIV and AIDS showed an increasing trend in China from 2004 to 2014, respectively, but the epidemic tended to be under control among provinces and young people that used to have a high HIV and AIDS incidence. Northwest China and older people could be new "hop-spots" for HIV and AIDS risk.

Keywords: China; Epidemiology; HIV and AIDS; Incidence; Surveillance.

MeSH terms

Acquired Immunodeficiency Syndrome / epidemiology*
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
China / epidemiology
Epidemics
Female
HIV
HIV Infections / epidemiology*
Humans
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Population Surveillance
Severe Acute Respiratory Syndrome / epidemiology*
Severe Acute Respiratory Syndrome / virology
Young Adult

Abstract

MeSH terms

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