Chu Haitao, Gange Stephen J, Yamashita Traci E, Hoover Donald R, Chmiel Joan S, Margolick Joseph B, Jacobson Lisa P
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Epidemiol. 2005 Oct 15;162(8):787-97. doi: 10.1093/aje/kwi268. Epub 2005 Aug 31.
The authors evaluated population- and individual-level CD4-positive T-lymphocyte (CD4 cell) count trajectories over a 7-year period (July 1995-March 2004) following initiation of highly active antiretroviral therapy (HAART) in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. The study population included 404 human immunodeficiency virus (HIV)-infected men and 609 HIV-infected women who 1) had a CD4 cell count measurement available from their last pre-HAART study visit, 2) provided at least four post-HAART CD4 cell count measurements, and 3) reported HAART usage for at least 80% of the post-HAART visits. The CD4 cell count trajectory was analyzed by means of a Bayesian random change-point model. The results indicated that CD4 cell count trajectories for long-term frequent HAART users can be well modeled with change points at both the population and individual levels. At the population level, regardless of CD4 cell count before HAART initiation, the gains in CD4 cell count ended approximately 2 years after HAART initiation in both men and women. At the individual level, 35% of men in the Multicenter AIDS Cohort Study versus 25% of women in the Women's Interagency HIV Study had a statistically significant change in CD4 cell count trajectory within 7 years after HAART initiation.
在多中心艾滋病队列研究和女性机构间HIV研究中，作者评估了在开始高效抗逆转录病毒治疗（HAART）后的7年期间（1995年7月至2004年3月）人群和个体水平的CD4阳性T淋巴细胞（CD4细胞）计数轨迹。研究人群包括404名感染人类免疫缺陷病毒（HIV）的男性和609名感染HIV的女性，他们1）在HAART治疗前的最后一次研究访视时有CD4细胞计数测量值，2）提供了至少四次HAART治疗后的CD4细胞计数测量值，并且3）报告在至少80%的HAART治疗后访视中使用了HAART。通过贝叶斯随机变化点模型分析CD4细胞计数轨迹。结果表明，长期频繁使用HAART的人群的CD4细胞计数轨迹在人群和个体水平上都可以通过变化点进行很好的建模。在人群水平上，无论HAART开始前的CD4细胞计数如何，男性和女性在HAART开始后约2年CD4细胞计数的增加就结束了。在个体水平上，多中心艾滋病队列研究中35%的男性与女性机构间HIV研究中25%的女性在HAART开始后7年内CD4细胞计数轨迹有统计学上的显著变化。
