Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Nantong, Jiangsu, China.
School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Sci Rep. 2017 May 8;7(1):1570. doi: 10.1038/s41598-017-01858-2.
The goal of this study was to assess risk factors associated with HIV/AIDS progression. Between May 2007 and December 2014, 114 subjects were enrolled in Wuxi City and examined every 6 months. The pol gene sequence was amplified to ascertain the HIV-1 subtype. A Cox proportional hazards regression model was used to estimate the factors associated with HIV/AIDS progression. The median follow-up time for all 114 subjects was 26.70 months (IQR: 18.50-41.47), while the median progression time of the 38 progressed subjects was 24.80 months (IQR: 14.13-34.38). Overall, the CRF01_AE subtype was correlated with a significant risk of accelerated progression compared to non-CRF01_AE subtypes (HR = 3.14, 95%CI: 1.39-7.08, P = 0.006). In addition, a lower CD4 count (350-499) at baseline was associated with a risk of accelerated HIV/AIDS progression compared to higher CD4 count (≥500) (HR = 4.38, 95%CI: 1.95-9.82, P < 0.001). Furthermore, interaction analyses showed that HIV-1 subtypes interacted multiplicatively with transmission routes or CD4 count at baseline to contribute to HIV/AIDS progression (P = 0.023 and P < 0.001, respectively). In conclusion, the CRF01_AE subtype and a lower CD4 count at baseline tend to be associated with the faster progression of HIV/AIDS. Understanding the factors affecting HIV/AIDS progression is crucial for developing personalized management and clinical counselling strategies.
本研究旨在评估与 HIV/AIDS 进展相关的风险因素。2007 年 5 月至 2014 年 12 月,共有 114 例受试者在无锡市入组,并每 6 个月进行一次检查。扩增 pol 基因序列以确定 HIV-1 亚型。采用 Cox 比例风险回归模型来估计与 HIV/AIDS 进展相关的因素。所有 114 例受试者的中位随访时间为 26.70 个月(IQR:18.50-41.47),而 38 例进展受试者的中位进展时间为 24.80 个月(IQR:14.13-34.38)。总体而言,与非 CRF01_AE 亚型相比,CRF01_AE 亚型与加速进展显著相关(HR=3.14,95%CI:1.39-7.08,P=0.006)。此外,与较高的 CD4 计数(≥500)相比,基线时较低的 CD4 计数(350-499)与加速 HIV/AIDS 进展的风险相关(HR=4.38,95%CI:1.95-9.82,P<0.001)。此外,交互分析表明,HIV-1 亚型与基线时的传播途径或 CD4 计数呈乘法交互作用,从而促进 HIV/AIDS 的进展(P=0.023 和 P<0.001)。综上所述,CRF01_AE 亚型和基线时较低的 CD4 计数往往与 HIV/AIDS 更快进展相关。了解影响 HIV/AIDS 进展的因素对于制定个性化管理和临床咨询策略至关重要。