山东省557例HIV/AIDS抗病毒治疗后CD4+/CD8+比值变化及相关因素分析  

Variation of CD4+/CD8+ratio and related influencing factors of HIV/AIDS after receiving antiretroviral treatment in Shandong province

作　　者：李金海[1] 张娜[1] 林彬[1] 孙晓光[1] 于海英[1] 苏生利[1] 黄涛[1] 朱晓艳[1] 韩磊[1] 王国永[1] 康殿民[1] Li Jinhai;Zhang Na;Lin Bin;Sun Xiaoguang;Yu Haiying;Su Shengli;Huang Tao;Zhu Xiaoyan;Han Lei;Wang Guoyong;Kang Dianmin(Shandong Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东省疾病预防控制中心,济南250014

出　　处：《中华实验和临床病毒学杂志》2020年第5期472-477,共6页Chinese Journal of Experimental and Clinical Virology

基　　金：山东省医药卫生科技发展计划(2019WS428)。

摘　　要：目的了解山东省HIV/AIDS接受抗病毒治疗后CD4+/CD8+比值变化情况及相关影响因素。方法回顾性收集山东省2010—2015年首次接受抗病毒治疗、年龄≥15周岁HIV/AIDS的基线及治疗后6个月、1年、2年、3年、4年和5年时的CD4+、CD8+T淋巴细胞计数等随防资料,采用秩和检验和广义估计方程(GEE)描述和分析不同治疗时间的CD4+/CD8+比值变化情况及相关影响因素。结果共纳入研究对象557例,基线CD4+/CD8+比值中位数0.20,99.82%患者的CD4+/CD8+比值发生倒置;CD4+/CD8+比值>1的患者所占比例基线为0.18%,经治疗5年后上升至13.11%,时间变化趋势有统计学意义(χ2=95.01,P<0.05)。多因素广义估计方程分析结果显示,基线CD4+T淋巴细胞计数水平和基线症状/体征情况是影响CD4+/CD8+比值变化的主要影响因素。结论山东省HIV/AIDS抗病毒治疗5年后CD4+/CD8+比值明显提升,患者治疗基线CD4细胞水平和基线症状/体征情况是影响CD4+/CD8+比值恢复的主要影响因素。Objective To investigate the variation of CD4+/CD8+ratio and related influencing factors after receiving antiviral treatment for HIV/AIDS in Shandong province.Methods HIV/AIDS patients in Shandong province initially received HAART from 2010 to 2015,at least 15 years old with the CD4+T and CD8+T cell count tested at baseline,6 months,1 year,2 years,3 years,4 years and 5 years after treatment initiation were selected.According to their retrospectively collected baseline and follow-up data,the variation of CD4+/CD8+and the related influencing factors were described and analyzed by using rank sum test and generalized estimating equation(GEE).Results A total of 557 subjects were included in the study.The median baseline CD4+/CD8+ratio was 0.20,and the CD4+/CD8+ratio was inverted in 99.82%of the patients.The proportion of patients with CD4+/CD8+ratio>1 was 0.18%at baseline,and increased to 13.11%after 5 years of treatment.The trend of time change was statistically significant(χ2=95.01,P<0.05).The result of GEE analysis showed that baseline CD4+T lymphocytes count level and baseline symptoms/signs were the main factors influencing the variation trend of CD4+/CD8+ratio.Conclusions After 5 years of antiviral treatment with HIV/AIDS in Shandong province,the CD4+/CD8+ratio increased significantly.Baseline CD4+T cell count level and baseline symptoms/signs of patients are the main factors affecting the rate of improvement of CD4+/CD8+ratio.

关 键 词：艾滋病 高效抗反转录病毒治疗 CD4+/CD8+ 影响因素 

分 类 号：R512.91[医药卫生—内科学]