Micheloud Dariela, Berenguer Juan, Bellón Jose M, Miralles Pilar, Cosin Jaime, de Quiros Juan Carlos Lopez-Bernaldo, Conde Matilde Sánchez, Muñoz-Fernández M Angeles, Resino Salvador
Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
J Infect. 2008 Feb;56(2):130-6. doi: 10.1016/j.jinf.2007.12.001. Epub 2008 Jan 14.
To study the effect of age on several outcomes among 187 antiretroviral-naive infected patients who started highly active antiretroviral therapy (HAART) with <or=200 CD4(+)/microl.
We carried out a retrospective study to determine the hazard ratio (HR) to reach an outcome in patients who experienced a change from the baseline in CD4(+) counts of at least +100, +200, +300, +400 and +500 cells/microl at any moment during the follow-up and the odds ratio (OR) of achieving and maintaining a CD4(+) value above a certain setpoint during at least 6, 12 or 18 months.
The adjusted HR for an increase of +400 CD4(+)/microl and +500 CD4(+)/microl were 1.3 (95% CI: 1.1; 1.5) and 1.3 (95% CI: 1.1; 1.6) times slower for each additional 5 years of age at baseline. In addition, for every 5 years of extra age, the adjusted OR to achieve an absolute CD4(+) cell count >500/microl at 6, 12 and 18 months after the initiation of HAART were 2.2 (95% CI: 1.5; 3.2), 1.8 (95% CI: 1.2; 2.6), and 1.8 (95% CI: 1.2; 2.9) times less likely, respectively. We also found that patients >or=45 years old had worse complete CD4(+) recovery (CD4(+)>500 cells/microl) than patients <45 years old.
The CD4(+) recovery after HAART is a prolonged and continuous process which extends for several years. Age at baseline is inversely correlated with the magnitude and speed of CD4(+) recovery among HIV-1 infected patients.
研究年龄对187例开始接受高效抗逆转录病毒治疗（HAART）且初始CD4(+)细胞计数≤200/μl的未接受过抗逆转录病毒治疗的感染患者多种结局的影响。
我们进行了一项回顾性研究，以确定在随访期间任何时刻CD4(+)细胞计数从基线至少增加+100、+200、+300、+400和+500细胞/μl的患者达到某一结局的风险比（HR），以及在至少6、12或18个月内实现并维持CD4(+)值高于某一设定点的比值比（OR）。
基线时每增加5岁，CD4(+)细胞计数增加+400/μl和+500/μl的校正HR分别慢1.3倍（95%置信区间：1.1；1.5）和1.3倍（95%置信区间：1.1；1.6）。此外，基线时每增加5岁，在开始HAART后6、12和18个月时达到绝对CD4(+)细胞计数>500/μl的校正OR分别低2.2倍（95%置信区间：1.5；3.2）、1.8倍（95%置信区间：1.2；2.6）和1.8倍（95%置信区间：1.2；2.9）。我们还发现，年龄≥45岁的患者与年龄<45岁的患者相比，CD4(+)完全恢复（CD4(+)>500细胞/μl）情况更差。
HAART后的CD4(+)恢复是一个持续数年的漫长过程。基线年龄与HIV-1感染患者CD4(+)恢复的幅度和速度呈负相关。
