HIV感染者/AIDS患者抗病毒治疗后CD4^(+)T淋巴细胞计数变化趋势  

Trends of CD4^(+)T lymphocyte counts in HIV infected/AIDS patients after antiviral treatment

作　　者：杨海花 李梦学 李缘 李健健 张米 邓雪媚 王佳丽 张念 刘家法 YANG Haihua;LI Mengxue;LI Yuan;LI Jianjian;ZHANG Mi;DENG Xuemei;WANG Jiali;ZHANG Nian;LIU Jiafa(Department of Clinical Laboratory,Yunnan Provincial Hospital of Infectious Diseases,Kunming,Yunnan 650301,China;Department of Public Health Department,Yunnan Provincial Hospital of Infectious Diseases,Kunming,Yunnan 650301,China)

机构地区：[1]云南省传染病医院检验科,云南昆明650301 [2]云南省传染病医院公共卫生科,云南昆明650301

出　　处：《中国热带医学》2024年第10期1248-1252,共5页China Tropical Medicine

基　　金：云南省科技厅昆明医科大学应用基础研究联合专项基金项目(No.202201AY070001-208);云南省高层次卫生技术人才培养经费资助项目(No.H-2019047);昆明医科大学科技创新团队建设项目(No.TXTD202111)。

摘　　要：目的分析HIV感染者/AIDS患者中不同人群抗病毒治疗后CD4+T淋巴细胞(以下简称为CD4细胞)动态变化情况,旨在了解不同人群抗病毒治疗后CD4细胞的变化特点,为临床诊疗提供依据。方法采用回顾性队列研究的方法,根据纳入和排除标准,对云南省某医院2018—2019年2年间接受治疗的HIV感染者/AIDS患者进行了系统筛选,共纳入符合要求的患者605例作为研究对象。对抗病毒治疗的基线以及6、12、18、24个月的CD4细胞计数水平进行分析,以HIV感染者/AIDS患者基线采血时间为起点,最后随访时间为终点。结果605例患者中,年龄≤30岁的患者抗病毒治疗后CD4细胞水平高于>30岁的患者;未婚的患者CD4细胞水平高于其他婚姻状况的患者;使用A组、C组和E组治疗方案的患者CD4细胞水平比B组、D组患者高。患者在抗病毒治疗(antiretroviral therapy,ART)开始的6个月内CD4细胞计数增长较快,基线CD4细胞≤200个/μL的患者治疗2年后CD4细胞仍未达到正常水平,基线CD4细胞>200个/μL的患者ART后CD4细胞始终处于较高水平,治疗2年后达到正常水平。结论ART早期为CD4细胞的快速增长期,越早进行ART,CD4细胞水平恢复越快,HIV感染者/AIDS患者免疫功能恢复越好。因此我们应加大监测检测力度,越早发现感染者将越容易进行免疫功能重建,提高治疗效果,减少死亡风险,延长患者寿命。Objective To analyze the dynamic changes of CD4+T lymphocytes(hereinafter referred to as CD4 cells)in different populations after of HIV infected/AIDS patients antiviral treatment,aiming to understand the characteristics of CD4 cell changes in different populations after antiviral treatment and provide a basis for clinical diagnosis and treatment.Methods A retrospective cohort study was conducted on HIV infected/AIDS patients who received treatment in a hospital in Yunnan Province from 2018 to 2019.According to the inclusion and exclusion criteria,a total of 605 eligible patients were included as research subjects.Analyze the baseline of antiviral therapy and CD4 cell count levels at 6,12,18,and 24 months,with the baseline blood collection time of HIV infected/AIDS patients as the starting point and the last follow-up time as the endpoint.Results Among the 605 patients,patients aged≤30 years had higher CD4 cell levels after antiviral therapy than patients aged>30 years;unmarried patients had higher CD4 cells than married and divorced patients;patients who acquired HIV through homosexual transmission had higher CD4 cell levels than those with heterosexual transmission;patients with mother-to-child transmission had higher CD4 cells at some follow-up points than those with heterosexual transmission and intravenous drug users;patients using regimen groups A,C,and E had higher CD4 cells than those using regimen groups B and D.The CD4 cell count increased rapidly within the first 6 months of ART initiation.Patients with a baseline CD4 cell count of≤200 cells/μL did not reach normal levels after 2 years of treatment,while patients with a baseline CD4 cell count of>200 cells/μL maintained relatively higher CD4 cell levels throughout ART and reached normal levels after 2 years of treatment.Conclusions The early stage of ART is the rapid growth period of CD4 cells.The earlier the initiation of ART,the quicker the CD4 cell levels recover,leading to better immune function restoration in HIV infected/AIDS patients.There

关 键 词：艾滋病 抗病毒治疗 CD4细胞 

分 类 号：R512.91[医药卫生—内科学]