Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory for HIV/AIDS Research, Beijing, China.
HIV Med. 2020 Dec;21(11):722-728. doi: 10.1111/hiv.13023.
To describe the clinical characteristics and factors associated with CD4 T-cell count and CD4/CD8 ratio restoration in HIV mono-infected and HIV/HBV co-infected individuals, and to explore liver and renal functional changes in both groups.
A retrospective cohort study was performed including 356 HIV/HBV co-infected and 716 HIV mono-infected participants who initiated antiretroviral therapy (ART) during 2013-2017 in Beijing Youan Hospital, China. Demographic and clinical characteristics were compared between the two groups, using χ and Mann-Whitney non-parametric tests. Bivariate and multivariate Cox regression models were used to test their association.
Baseline HIV viral load and ART regimen were found to be significantly associated with CD4 T-cell restoration among HIV-infected participants, whereas baseline HIV viral load was the only significant factor associated with CD4 T-cell restoration in HIV/HBV co-infected participants. The final model showed that baseline HIV viral load and ART regimen were significantly associated with CD4/CD8 ratio restoration among HIV-infected participants, while baseline HIV viral load was the significant factor. Liver and renal functions were similar at the endpoint (P > 0.05).
Baseline HIV viral load count was found to be the key factor affecting immune restoration in both HIV and HIV/HBV individuals. Future multi-wave prospective studies are needed to clarify the potential biological mechanism.
描述 HIV 单一感染和 HIV/HBV 合并感染个体中 CD4 T 细胞计数和 CD4/CD8 比值恢复的临床特征及相关因素，并探讨两组患者的肝肾功能变化。
本研究为回顾性队列研究，纳入了 2013 年至 2017 年期间在中国北京佑安医院接受抗反转录病毒治疗（ART）的 356 例 HIV/HBV 合并感染和 716 例 HIV 单一感染患者。采用卡方检验和 Mann-Whitney 非参数检验比较两组患者的人口统计学和临床特征。采用单因素和多因素 Cox 回归模型分析其相关性。
研究发现，HIV 感染者的 CD4 T 细胞恢复与基线 HIV 病毒载量和 ART 方案显著相关，而 HIV/HBV 合并感染者的 CD4 T 细胞恢复仅与基线 HIV 病毒载量显著相关。最终模型显示，HIV 感染者的 CD4/CD8 比值恢复与基线 HIV 病毒载量和 ART 方案显著相关，而 HIV/HBV 合并感染者的 CD4/CD8 比值恢复仅与基线 HIV 病毒载量显著相关。终点时两组患者的肝肾功能相似（P＞0.05）。
基线 HIV 病毒载量是影响 HIV 和 HIV/HBV 个体免疫恢复的关键因素。未来需要开展多波前瞻性研究以阐明潜在的生物学机制。
