HIV/AIDS患者抗反转录病毒治疗后免疫重建不良患病率的Meta分析  

The prevalence of immune reconstitution dysfunction following antiretroviral therapy in HIV/AIDS patients:A meta-analysis

作　　者：宋爽 蒋运兰[2] 李滔 康静 杜秋凤 易晓冬 SONG Shuang;JIANG Yunlan;LI Tao;KANG Jing;DU Qiufeng;YI Xiaodong(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China)

机构地区：[1]成都中医药大学,成都610075 [2]成都中医药大学附属医院,成都610072

出　　处：《中国艾滋病性病》2024年第11期1211-1218,共8页Chinese Journal of Aids & STD

摘　　要：目的 系统评价HIV/AIDS患者cART后免疫重建不良的患病率。方法 计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library数据库,收集有关HIV/AIDS患者cART后免疫重建不良患病率的相关研究,检索时间限定为建库至2024年4月,运用Stata 14.0软件进行Meta分析。结果 纳入39项研究,总样本量29 458例,免疫重建不良患者6 735例。Meta分析结果显示,HIV/AIDS患者cART后免疫重建不良总患病率为24.3%(95%CI:19.3~29.7),我国HIV/AIDS患者免疫重建不良患病率为28.4%(95%CI:20.6~37.0)。亚组分析结果显示,男性、亚洲地区、经血源性传播感染、cART时长≤2年、基线CD4细胞<200个/μL、基线病毒载量≥1×105拷贝/mL、合并HBV或HCV感染的患者患病率更高。结论 当前证据表明,HIV/AIDS患者经cART后免疫重建不良患病率较高,不同特征的患者患病率存在差异,应重视高危人群免疫重建不良的监测随访和诊治,以促进免疫功能的良好恢复。Objective To systematically evaluate the prevalence of immune reconstitution dysfunction among HIV/AIDS patients following combination antiretroviral therapy(cART).Methods A comprehensive literature search was conducted across databases,including China National Knowledge Infrastructure(CNKI),VIP Chinese Journal Service Platform,Wanfang Data Knowledge Service Platform,the Chinese Biomedical Literature Database,PubMed,Embase,Web of Science,and the Cochrane Library.The search encompassed publications addressing the prevalence of immune reconstitution dysfunction among HIV/AIDS patients undergoing cART,from inception of each database until April 2024.A meta-analysis was performed using Stata 14.0 software.Results A total of 39 studies were included,comprising 29458 participants,of whom 6735 exhibited immune reconstitution dysfunction.The meta-analysis revealed an overall prevalence of immune reconstitution dysfunction of 24.3%(95%CI:19.3-29.7)among HIV/AIDS patients post cART.In China,the prevalence was 28.4%(95%CI:20.6-37.0).Subgroup analysis revealed higher prevalence among males,individuals from Asia,those infected via blood transmission,patients receiving cART for≤2 years,individuals with baseline CD4 counts<200 cells/μL,baseline viral loads≥1x105 copies/mL,and patients co-infected with HBV or HCV.Conclusions Current evidence suggests a relatively high prevalence of immune reconstitution dysfunction following cART among patients with HIV/AIDS,with variations observed across patient characteristics.Close monitoring,followup,and tailored interventions are essential to facilitate optimal immune recovery in high-risk populations.

关 键 词：艾滋病病毒感染者/艾滋病患者 抗反转录病毒治疗 免疫重建 患病率 META分析 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]