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女性与男性相比,CD4+T 淋巴细胞迅速减少和人类免疫缺陷病毒进展更快。

The rapid CD4 + T-lymphocyte decline and human immunodeficiency virus progression in females compared to males.

机构信息

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Sci Rep. 2020 Oct 8;10(1):16816. doi: 10.1038/s41598-020-73852-0.

DOI:10.1038/s41598-020-73852-0
PMID:33033335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7544823/
Abstract

CD4 + T-lymphocyte counts are used to assess CD4 + decline and the stage of human immunodeficiency virus (HIV) progression in HIV-infected patients. Clinical observation suggests that HIV progress more rapid in females than males. Of the original 5000 HIV-infected population of Western New York HIV/AIDS, Referral Center at Erie County Medical Center (ECMC), 1422 participated in the cohort study. We identified 333 HIV-infected patients with CD4 + T-cell-counts ≥ 500/µƖ, among them 178 met the inclusion criteria for the 10-year study. Females had higher mode (600 vs. 540) and mean (741.9 vs. 712.2) CD4 + counts than males at baseline. However, CD4 + declined faster among females in a shorter time than males (234.5 vs. 158.6, P < 0.004), with rapid HIV progression. Univariate analyses determined that females had a 40% higher risk for CD4 + decline than males. The bivariate analyses specified CD4 + decline remained greater in females than males. Multivariate analyses which employed Cox's proportional Hazard-Model to adjust for numerous variables simultaneously identified women had almost twice the risk for CD4 + decline and rapid HIV progression than males (RR = 1.93; 95%CI 1.24, 2.99). Although the biological mechanism remains unknown, findings suggest gender differences in CD4 + decline, with a higher risk of rapid HIV progression and shorter longevity in females.

摘要

CD4+T 淋巴细胞计数用于评估 HIV 感染患者的 CD4+细胞下降和 HIV 进展阶段。临床观察表明,女性 HIV 进展速度比男性快。在最初的 5000 名西纽约 HIV/AIDS 感染人群中,有 1422 名参加了 Erie County Medical Center (ECMC) 的 HIV 感染人群队列研究。我们确定了 333 名 CD4+T 细胞计数≥500/µl 的 HIV 感染患者,其中 178 名符合 10 年研究的纳入标准。女性在基线时的 CD4+计数中位数(600 比 540)和平均值(741.9 比 712.2)均高于男性。然而,女性 CD4+细胞下降速度比男性更快,下降幅度更大(234.5 比 158.6,P<0.004),HIV 进展更快。单变量分析确定女性 CD4+细胞下降的风险比男性高 40%。双变量分析表明,女性 CD4+细胞下降幅度仍然大于男性。多变量分析采用 Cox 比例风险模型同时调整多个变量,确定女性 CD4+细胞下降和 HIV 快速进展的风险几乎是男性的两倍(RR=1.93;95%CI 1.24,2.99)。尽管生物学机制尚不清楚,但研究结果表明 CD4+细胞下降存在性别差异,女性 HIV 快速进展和寿命缩短的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/05d8e5da6508/41598_2020_73852_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/10be47984cc6/41598_2020_73852_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/d4a91922a4b8/41598_2020_73852_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/05d8e5da6508/41598_2020_73852_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/10be47984cc6/41598_2020_73852_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/d4a91922a4b8/41598_2020_73852_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08d/7544823/05d8e5da6508/41598_2020_73852_Fig3_HTML.jpg

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