[Prevalence and related factors of CD4+T lymphocytes immune recovery among adult HIV/AIDS on antiretroviral therapy in Dehong Dai and Jingpo Autonomous Prefecture].

医学 逻辑回归 养生 抗逆转录病毒疗法 队列 人类免疫缺陷病毒(HIV) 人口学 抗逆转录病毒治疗 年轻人 内科学 病毒载量 免疫学 社会学
作者
Huiting Yu,Yue cheng Yang,Yuechao Zhao,Dan Cao,Cong Jin,R H Ye,Bin Zhu,X J Liu,Shuangquan Yao,Chang‐Hua Chen,Shaoqi Duan,Zun you Wu
出处
期刊:PubMed 被引量:2
标识
DOI:10.3760/cma.j.cn112338-20210326-00250
摘要

Objective: To analyze the longitudinal characteristics of CD4+T lymphocytes (CD4) among the adult HIV/AIDS on antiretroviral therapy (ART) and the related factors. Methods: A retrospective cohort of adult HIV/AIDS starting ART in Dehong Dai and Jingpo Autonomous Prefecture (Dehong) in 2007-2016 was followed up to December 31, 2018. Group-based trajectory models were utilized to identify CD4 subgroups based on immune recovery (whether and when CD4 reached the average level of >500 cells/μl). The demographics and information at ART baseline were described, and the related factors were analyzed with polytomous logistic regression. The SAS 9.4 software was used for statistical analysis. Results: A total of 7 605 adults with HIV/AIDS were included, of which the median (P25,P75) age at ART were 36 (30,43) years old, 61.0% were male, 42.5% were Han nationality, and 60.8% with the education of primary school or below. The follow-up duration M (P25, P75) was 6.1 (4.1,8.1) years. HIV/AIDS in Dehong showed four CD4 trajectory subgroups from low to high: below the average level, primary recovery to a normal level, full recovery to a moderate level, and normal steady level, accounting for 34.4%, 39.8%, 20.6%, and 5.2%, respectively. When compared with corresponding control groups, age <35 years at ART, female, education of middle school or above, sexual transmission, no opportunistic infection, CD4 ≥200 cells/μl, baseline regimen with tenofovir (TDF) and time from HIV diagnosis to ART <1 year were the related factors facilitating the higher CD4 subgroups. Conclusions: The various CD4 immune recoveries of HIV/AIDS were changing patterns after ART. Starting ART with a high CD4 level was beneficial to CD4 recovery to normal level during the follow-up period. Early initiation of ART and exceptional attention to CD4 immune recovery should be encouraged after the ART.目的: 分析德宏傣族景颇族自治州(德宏州)成年人HIV/AIDS开始抗病毒治疗(ART)后CD4+T淋巴细胞(CD4)纵向变化特征及其影响因素。 方法: 对德宏州2007-2016年开始ART的成年人HIV/AIDS的回顾性队列随访至2018年12月31日。免疫重建良好的定义为HIV/AIDS经ART后CD4恢复至基本正常(>500个/µl),据此将HIV/AIDS分为4个组,采用轨迹分析模型描述和分析每组ART后CD4免疫重建情况,采用多因素logistic回归分析其影响因素。采用SAS 9.4软件进行统计学分析。 结果: 研究对象共7 605例HIV/AIDS,开始ART年龄M(P25,P75)为36(30,43)岁,男性4 641例(61.0%),汉族3 232例(42.5%),小学及以下文化程度4 624例(60.8%),随访时间M(P25,P75)为6.1(4.1,8.1)年。CD4未恢复正常组、CD4基本恢复正常组、CD4恢复正常组和CD4维持正常组的构成比分别为34.4%(2 617)、39.8%(3 030)、20.6%(1 562)和5.2%(396)。与CD4未恢复正常组作为对照组相比,开始ART年龄<35岁、女性、中学及以上文化程度、性传播感染途径、基线无机会性感染、开始ART时CD4≥200个/μl、含替诺福韦(TDF)标准的ART方案、确诊到开始ART时间<1年是促进HIV/AIDS的CD4免疫重建良好的影响因素。 结论: 德宏州ART后HIV/AIDS的CD4免疫重建情况呈多种状况,在基线CD4较高水平时开始ART有助于CD4恢复至正常水平。建议尽早开始ART,注意随访和关注CD4水平变化。.
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