2014—2019年山西省艾滋病免费抗病毒治疗的免疫学效果分析  

Immunological effect of free antiretroviral therapy among HIV/AIDS patients in Shanxi from 2014 to 2019

作　　者：孟珺[1] 聂晓勇[1] 原琛利[1] 郭晓黎[1] 张飞[1] 解雁茹 刘萧湘 焦晋 MENG Jun;NIE Xiao-yong;YUAN Chen-li;GUO Xiao-li;ZHANG Fei;XIE Yan-ru;LIU Xiao-xiang;JIAO Jin(Shanxi Center for Disease Control and Prevention,Taiyuan 030012,Shanxi Province,China)

机构地区：[1]山西省疾病预防控制中心,太原030012

出　　处：《预防医学情报杂志》2022年第7期921-926,共6页Journal of Preventive Medicine Information

摘　　要：目的分析山西省2014—2019年艾滋病高效抗逆转录病毒治疗(HAART)的免疫学效果及其相关影响因素。方法收集山西省2014—2018年内所有首次接受HAART的艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS患者)入组的基本情况和治疗后6个月、12个月、24个月、36个月、48个月和60个月的随访信息,观察截止日期为2019-12,采用Wilcoxon符号秩检验分析治疗后不同治疗时间段的CD4^(+)T淋巴细胞变化情况,采用Logistic回归分析抗病毒治疗免疫学效果的影响因素,分析均由SPSS 23.0软件统计完成,检验水准(双侧检验)均为0.05。结果共有3876例研究对象纳入研究,治疗前基线CD4^(+)T淋巴细胞中位数为301(IQR:152~425)个/μl,治疗后60个月的CD4^(+)T淋巴细胞中位数增涨至503(IQR:332~673)个/μl,治疗后各时间段与基线始点的CD4^(+)T淋巴细胞中位数之间的差异以及治疗后各时间段与相应的前一个时间段的CD4^(+)T淋巴细胞中位数之间的差异均具有统计学意义(P<0.05),治疗后6个月的CD4^(+)T淋巴细胞中位数较基线上升数量最多,增长值中位数为94(16~184)个/μl(Z=-30.106,P<0.01),之后幅度逐渐放缓。治疗12个月后的免疫应答成功率是63.9%,Logistic多因素分析显示初始治疗方案含有替诺福韦(TDF)、WHO临床分期处于Ⅲ期或Ⅳ期、确证HIV阳性到启动治疗时间间隔<6个月的HIV/AIDS患者治疗12个月后获得的免疫应答成功率较高。结论山西省HIV/AIDS患者接受HAART后取得较好的免疫学效果,优化治疗药物方案,推行“早发现、早治疗”策略有利于进一步提升抗病毒治疗免疫学效果。Objective To analyze the immunological effect and its influencing factors of highly active antiretroviral therapy(HAART)among patients with immunodeficiency virus/acquired immunodeficiency syndromes(HIV/AIDS)in Shanxi Province from 2014 to 2019.Methods HIV-infected persons/AIDS patients who started HAART for the first time in Shanxi from 2014 to 2018 were enrolled into the research,and the basic information of enrollment and follow-up data after 6,12,24,36,48 and 60 months of treatment were collected.The observation deadline was December 2019.Wilcoxon signed rank test was used to analyze the variation of CD4^(+)T cell count after different time periods of treatment.Logistic regression model was performed to explore the factors influencing the immunological effect of antiretroviral therapy.All analyses were conducted by SPSS 23.0 software,and the test level(bilateral test)was 0.05.Results There were totally 3876 cases enrolled in the research.The median of CD4^(+)T cell count at baseline before treatment was 301 cells/μL,with the interquartile range(IQR)of 15-425.And the median increased to 503(IQR:332-673)cells/μL after 60 months of HAART treatment.The differences of the median of the CD4^(+)T lymphocyte counts were statistically significant between each of the different time periods of treatment and the baseline,as well as between each time period and the previous time period of treatment(P<0.05).The median of CD4^(+)T lymphocytes count increased the most at 6 months after treatment by 94(IQR:16-184)cells/μL compared with the baseline(Z=-30.106,P<0.01).And then the increasement gradually slowed down.The success rate of immunological response after 12 months of treatment was 63.9%.The multivariate logistic analysis showed that the following situation had a higher success rate of immunological effect:initial treatment regimen contained tenofovir(TDF),the World Health Organization(WHO)clinical stage wasⅢ or Ⅳ,and 12 months of treatment among patients with an interval of less than 6 months between confirmed H

关 键 词：人类免疫缺陷病毒 高效抗逆转录病毒治疗 免疫学效果 

分 类 号：R512.91[医药卫生—内科学]