Moore A L, Mocroft A, Madge S, Devereux H, Wilson D, Phillips A N, Johnson M
Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Hampstead, London, United Kingdom.
J Acquir Immune Defic Syndr. 2001 Feb 1;26(2):159-63. doi: 10.1097/00042560-200102010-00008.
To establish whether a gender difference in virologic response to highly active antiretroviral treatment (HAART) exists.
A cohort of HIV-positive individuals was examined.
Achievement of viral load <500 copies/ml and "failure" (failure to suppress viral load <500 copies/ml after 24 weeks or two consecutive measurements above this level after having suppressed below it). Hazard ratios (HRs) comparing the rate in women to that in men were derived using the Cox model.
Of 366 male subjects, 79% were white and 82% were homosexual. Sixty-three percent of the 91 female subjects were African and 87% were heterosexual. The median follow-up after HAART was 94 weeks. The baseline CD4 count was higher in men (228 x 106 per liter) than in women (171 x 106 per liter) (p =.01), but the viral load was similar (p =.88). The median time to <500 copies/ml was 16 weeks. Women achieved a viral load of <500 copies/ml at a faster rate than men, with an adjusted HR of 1.46 (95% confidence interval [CI]: 0.99-2.16; p =.06). Some 261 patients failed treatment (58% of men and 53% of women) with an HR of 0.78 (95% CI: 0.51-1.21; p =.27).
Women may achieve virologic suppression at a faster rate than men and have a more durable response. Further research should examine these responses in conjunction with clinical outcomes, because gender differences in virologic response may ultimately be of little relevance if clinical outcomes are similar.
确定在高效抗逆转录病毒治疗（HAART）的病毒学反应中是否存在性别差异。
对一组HIV阳性个体进行检查。
病毒载量达到<500拷贝/毫升以及“治疗失败”（24周后病毒载量未能抑制到<500拷贝/毫升，或在曾抑制到该水平以下后连续两次测量高于此水平）。使用Cox模型得出女性与男性发生率比较的风险比（HRs）。
在366名男性受试者中，79%为白人，82%为同性恋者。91名女性受试者中63%为非洲人，87%为异性恋者。HAART后的中位随访时间为94周。男性的基线CD4细胞计数（每升228×10⁶）高于女性（每升171×10⁶）（p = 0.01），但病毒载量相似（p = 0.88）。达到<500拷贝/毫升的中位时间为16周。女性达到病毒载量<500拷贝/毫升的速度比男性快，校正后的HR为1.46（95%置信区间[CI]：0.99 - 2.16；p = 0.06）。约261名患者治疗失败（男性为58%，女性为53%），HR为0.78（95% CI：0.51 - 1.21；p = 0.27）。
女性可能比男性更快实现病毒学抑制且反应更持久。应结合临床结果对这些反应进行进一步研究，因为如果临床结果相似，病毒学反应中的性别差异最终可能无关紧要。
