Wen Ying, Ding Hai Bo, Chen Wei, Zhou Ying, Wang Wen, Wang Yu, Lu Xu, Liu Jing, Kang Jing, Geng Wenqing, Shang Hong, Liu Pei
Department of Infectious Diseases, The First Affiliated Hospital Department of Laboratory Medicine, Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning Province Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou Shenyang Chest Hospital, Shenyang, Liaoning Province, China.
Medicine (Baltimore). 2016 Dec;95(52):e5732. doi: 10.1097/MD.0000000000005732.
To assess the effect that hormonal disturbances have on HIV prognosis in male patients. A prospective follow-up study was conducted among male HIV patients who started antiretroviral therapy (ART) between July 1, 2011 and June 30, 2014. The final follow-up session occurred before December 31, 2014. We examined the correlation between pre-ART hormone levels and disease prognosis. The Kaplan-Meier method and the multivariate Cox proportional hazard model were used to identify hormone-related predictors of immunological failure and mortality. During the follow-up of 163 male HIV patients, mortality rate occurred at a rate of 16.0% (26/163). Of these deaths, 84.6% (22/26) were acquired immunodeficiency syndrome-related. Furthermore, 53 patients were found to have suffered from immunological failure. Both pre-ART CD4+ T cell counts and the clinical stage assigned to the patients correlated strongly with dehydroepiandrosterone sulfate levels. Hyponatremia, high cortisol levels, tuberculosis, and being at World Health Organization (WHO)-defined clinical stage 4 were characteristics that associated significantly with mortality. Being at WHO clinical stage 4 was, itself, a factor that significantly associated with immunological failure. High cortisol levels were found to be an important hormonal disorder that associated with mortality. None of the hormones examined in this study had a strong correlation with immunological failure.
为评估激素紊乱对男性艾滋病患者预后的影响。对2011年7月1日至2014年6月30日期间开始接受抗逆转录病毒治疗（ART）的男性艾滋病患者进行了一项前瞻性随访研究。最后一次随访在2014年12月31日前进行。我们研究了ART前激素水平与疾病预后之间的相关性。采用Kaplan-Meier法和多变量Cox比例风险模型来确定与免疫失败和死亡率相关的激素预测指标。在对163名男性艾滋病患者的随访中，死亡率为16.0%（26/163）。在这些死亡病例中，84.6%（22/26）与获得性免疫缺陷综合征相关。此外，发现53名患者出现了免疫失败。ART前CD4+T细胞计数和患者的临床分期均与硫酸脱氢表雄酮水平密切相关。低钠血症、高皮质醇水平、结核病以及处于世界卫生组织（WHO）定义的临床4期是与死亡率显著相关的特征。处于WHO临床4期本身就是一个与免疫失败显著相关的因素。高皮质醇水平被发现是一种与死亡率相关的重要激素紊乱。本研究中检测的激素均与免疫失败无强相关性。
