Study Design, Period, and Setting
A retrospective cohort study was conducted in Henan province, which is in center of China, based on standard medical record registers. Most HIV-infected people in Henan are living in resource limited regions and were infected through paid blood supply and illegal blood plasma collecting in the 1990s and was diagnosed with HIV from 2003[12]. In 2003, China initiated a large-scale program for providing HAART free of charge. The main first-line therapy regimen comprised zidovudine (AZT)/stavudine (D4T) + didanosine (DDI) + nevirapine (NVP). However, in 2009, adult patients who experienced failure of the first-line treatment protocol have to switch to second-line ART, comprising lamivudine (3TC) + tenofovir (TDF) + lopinavir/ritonavir (Lpv/r) [13]. Henan was one of the earliest areas to begin free first-line and second-line ART as described in the National Free Antiretroviral Treatment Program (NFATP). Since 2004, the State Administration of Traditional Chinese Medicine has sponsored a national CM–AIDS Treatment Trial Program (NCMATP) for PLHIV in Henan province and this program reported elsewhere [14-16]. The information of PLHIV researched in this study were collected in the medical record registers of NFATP and NCMATP.