津巴布韦高 CD4 细胞计数的 HIV 阳性产后妇女的死亡率。
Mortality among HIV-positive postpartum women with high CD4 cell counts in Zimbabwe.
机构信息
DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa.
出版信息
AIDS. 2010 Jan 28;24(3):F11-4. doi: 10.1097/qad.0b013e328335749d.
BACKGROUND
Whereas HAART initiated at CD4 cell counts 351-450 cells/ml reduces mortality, compared with starting at lower CD4 levels, there is currently no evidence for the advantages of initiating treatment at CD4 cell counts greater than 450 cells/ml.
METHODS
Mortality hazard, as a function of CD4 cell count, was estimated among postpartum HIV-positive women in Zimbabwe, using HIV-negative women as the reference group.
RESULTS
Mortality within 24 months postpartum was 54 times higher among women with CD4 cell counts less than 200 cells/ml, fell to 5.4 times higher for those with CD4 cell counts 400-600 cells/ml but fell little thereafter. For CD4 cell counts greater than 600 cells/ml the hazard was 6.2 (95% confidence interval 3.2-11.9).
CONCLUSION
Early HAART initiation for all HIV-positive pregnant women may benefit individual mothers and infants, and simultaneously reduce population HIV incidence.
背景
与在 CD4 细胞计数低于 351 个细胞/ml 时开始接受 HAART 相比，在 CD4 细胞计数 351-450 个细胞/ml 时开始接受 HAART 可降低死亡率，但目前尚无证据表明在 CD4 细胞计数高于 450 个细胞/ml 时开始治疗有优势。
方法
采用 HIV 阴性女性作为参照组，评估津巴布韦产后 HIV 阳性女性中 CD4 细胞计数与死亡率之间的关系。
结果
产后 24 个月内，CD4 细胞计数小于 200 个细胞/ml 的女性死亡率是 HIV 阴性女性的 54 倍，CD4 细胞计数为 400-600 个细胞/ml 的女性死亡率下降到 5.4 倍，但此后死亡率下降幅度不大。CD4 细胞计数大于 600 个细胞/ml 的女性的风险为 6.2（95%置信区间为 3.2-11.9）。
结论
所有 HIV 阳性孕妇均早期开始 HAART 治疗可能使母婴个体受益，同时降低人群 HIV 发病率。
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