湖南省AIDS病人HAART过程中影响免疫功能重建的因素分析  

Analysis on Influential Factors of Immune Restoration in HAART in Hunan Province

作　　者：魏秀青[1] 陈曦[1] 贺健梅[1] 张园园[1] 张国强[1] 彭瑾瑜[1] 

机构地区：[1]湖南省疾病预防控制中心,长沙410005

出　　处：《中国艾滋病性病》2015年第11期922-925,共4页Chinese Journal of Aids & STD

基　　金：湖南省卫生厅科研基金课题(C2014-039)~~

摘　　要：目的分析高效抗反转录病毒治疗（HAART）过程中影响免疫功能重建的因素。方法 2003年9月至2013年6月,采用回顾式队列分析,从国家艾滋病抗病毒治疗数据库中筛选出按要求完成随访的病人5567例,检测病人基线及HAART治疗9-15个月后的CD＋4T淋巴细胞（简称CD4细胞）数量,将CD4细胞〈200个/μL或较基线增长〈20%定义为免疫重建不良,采用Logistic回归分析观察其影响因素。结果 HAART有效率为54.25%,共有2547例病人发生免疫重建不良,男性[比值比（OR）：1.58,95%可信区间（CI）：（1.41-1.76）]、高龄[-60岁OR：2.25,95%CI：（1.38-3.67）]、〉60岁OR：2.57,95%CI：（1.54-4.31）]、静脉吸毒、基线CD4细胞水平过低、合并丙型肝炎病毒（HCV）[OR：1.68,95%CI（1.26-2.24）]感染、结核菌（TB）感染、病毒抑制不良[〉5000拷贝OR：4.05,95%CI：（2.82-5.82）]等,均是发生免疫重建不良的危险因素,而乙型肝炎病毒表面抗原（HBsAg）阳性未发现与免疫重建相关[OR：0.90,95%CI：（0.71-1.16）]。结论男性、高龄、静脉吸毒、基线CD4细胞水平过低、合并HCV感染、病毒抑制不良等,均是发生免疫重建不良的危险因素,临床上需引起注意。Objective To analyze the efficacy and its influencing factorso fhighly active antiretroviral therapy（HAART）.Methods From Sept.2003,to Jun.2013,a retrospective cohort analysis was conducted on the 5567 cases of AIDS patientsbased on the data base of the National AIDS antiretroviral treatment,who were followed-up as required.CD＋4T lymphocyte count was detected as baseline when their HAART started and tested again after 9-15 months HAART treatment.The CD＋4T 200/μL or growth of CD4cells20% compared with that of baseline was defined as adverse immune reconstitution.Logistic regression was analyzed to know the influencing factors.Results A total number of 2547 cases of AIDS patients had poor immune reconstitution with HAART effective rate54.25%.The risk factors for the adverse immune reconstitution included men[OR：1.58,95% CI：（1.41-1.76）],age[60years of age OR：2.25,95% CI：（1.38-3.67）;ages above 60 years OR：2.57,95% CI：（1.54-4.31）],intravenous drug use,lower baseline CD＋4T lymphocytes,co-infection with HCV [OR：1.68,95% CI：（1.26-2.24）],TB infection,and adverse virus inhibition[5000copy above OR：4.05,95% CI：（2.82-5.82）].It was found that HBsAg positive was not correlated with immune reconstitution[OR：0.90,95% CI：（0.71-1.16）].Conclusions Male,advanced age,injecting drug-users,lower baseline CD4,and high viral load are all risk factors of poor immune response.

关 键 词：艾滋病病人 高效抗反转录病毒治疗 免疫功能重建 影响因素 

分 类 号：R512.91[医药卫生—内科学] R512.9[医药卫生—临床医学]