实用医学杂志 ›› 2021, Vol. 37 ›› Issue (23): 3047-3051.doi: 10.3969/j.issn.1006⁃5725.2021.23.017

• 临床研究 • 上一篇    下一篇

艾滋期HIV患者HAART后免疫重建不良的基线相关因素分析

王立洋1 唐诗2 闻颖2   

  1.  1 沈阳市第六人民医院消化科(沈阳 110001);2 中国医科大学附属第一医院传染科(沈阳110001)
  • 出版日期:2021-12-10 发布日期:2021-12-10
  • 通讯作者: 闻颖 E⁃mail:wenying666466@163.com

Baseline related factors of suboptimal immune responders after antiretrovival therapy in HIV patients dur⁃ ing AIDS

WANG Liyang*,TANG Shi,WEN Ying.    

  1. Department of Gastroenterology,the Sixth People′s Hospital of Shenyang,Shenyang 110001,China

  • Online:2021-12-10 Published:2021-12-10
  • Contact: WEN Ying E⁃mail:wenying666466@163.com

摘要:

目的 分析抗逆转录病毒治疗(antiretroviral therapy,ART)至少 96 周并获得持续病毒学抑制且排除耐药的艾滋期人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者出现免疫重建不良 suboptimal immune responders,SIR)的 ART 前基线危险因素,尤其是基线巨细胞病毒(cytomegalovirus CMV)的感染状态与 SIR 的相关性。方法 收集 ART 至少 96 周并获得持续病毒学抑制(HIV RNA < 50 copies/mL)的艾滋病期 HIV 患者为研究对象,根据 ART 96 CD4+T 计数是否小于 200 个/μL 分为免疫重 建良好(optimal immune responders,OIR)组和 SIR 组,回顾性分析 SIR 的基线危险因素,比较两组之间基线 因素有否差异,回归分析与 SIR 相关的基线危险因素。结果 共入组 87 例,29 例为 SIR,占 33.3%,OIR 58 例。两组在基线 CD4+T 计数、CD8+T 计数、CMV DNA、卡氏肺孢子菌肺炎、WHO 临床分期、CMV 感染有 统计学差异。logistic 回归:年龄≥ 50 岁、基线 CD4+T 计数< 100 个/μL SIR 的基线危险因素。结论 艾滋 HIV 患者,年龄≥ 50 岁及基线 CD4+T 计数< 100 个/μL SIR 的基线危险因素,而基线 CMV 感染状态不 SIR 相关。

Abstract:

Objective To analyze the baseline related factors of suboptimal immune responders after anti⁃ retroviral therapy(ART)and investigate the association of baseline cytomegalovirus(CMV)of suboptimal immune responders (SIR). Methods The patients who received ART treatment for at least 96 weeks and achieved sustained virologic suppression(HIV RNA < 50 copies/mL)of AIDS patients were included in the study as the research objects. According to the count of CD4+ T at week 96 after ART,the patients were divided into the optimal immune responders(OIR,CD4+ T count ≥ 200 μL)group and SIR group(CD4+ T count < 200 μL). Baseline risk factors of SIR were retrospectively analyzed. Multiple regression analyses were done to assess the correlation of base⁃ line risk factors with SIR. Results 87 patients were included according to the inclusion standard in the study,with 29 in the SIR group with a ratio of 33.3%,and 58 in the OIR group. There were significantly differences in base⁃ line CD4 + T count,baseline CD8 + T count,CMV DNA,Pneumocystis carinii pneumonia,WHO clinical staging CMV infection. By Logistic regression analysis,the age of ≥ 50 years and the count of baseline CD4+ T < 100 /μL were the relevant baseline risk factors for SIR at week 96 after ART. Conclusions The baseline risk factors for SIR at week 96 after ART include AIDS HIV-infected individuals,patient aged ≥ 50 years and baseline CD4 +T count < 100 /μL and baseline CMV infection status is not associated with SIR.

Key words:

human immunodeficiency virus, cytomegalovirus, antiretroviral therapy, suboptimal immune responder