Short-term exposure to ambient particulate matter and mortality among HIV/AIDS patients: Case-crossover evidence from all counties of Hubei province, China.

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been a worrisome public health problem in the world. However, evidence for associations between short-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients is scarce.

Methods: We collected daily death records in people with HIV/AIDS from all counties (N = 103) of Hubei province, China from 2018 to 2019. The county-level daily concentrations of PM, PM and PM in the same period were extracted from ChinaHighAirPollutants dataset. A time-stratified case-crossover design with conditional logistic regression analysis was performed to assess the associations between PM and mortality.

Results: Each 1 μg/m increased in PM corresponded with 0.89 % elevated in all-cause deaths (ACD) at lag 0-4 days. The largest effects of PM, PM and PM on AIDS-related deaths (ARD) were detected at lag 0-4 days, and PM [percent changes in odds ratio: 2.51 % (95 % CIs: 0.82, 4.22)] appeared greater health hazards than PM [1.24 % (95 % CIs: 0.33, 2.15)] as well as PM [0.65 % (95 % CIs: 0.01, 1.30)]. In subgroup analyses, the significant associations of PM/PM and ACD were only found in male and the cold season. We also observed the effects of PM and PM on ARD were significantly stronger (P for interaction <0.05) in males than females. In addition, we caught sight of HIV/AIDS patients aged over 60 years old were more susceptible to ARD caused by PM than younger population.

Conclusions: Our study suggested PM was positively linked with the risk of ACD and ARD. Male patients with HIV/AIDS were more significantly susceptible to PM, PM and PM. PM/PM appeared stronger associations with ARD in HIV/AIDS patients aged over 60 years old and in the cold season.