Department of Science and Technology and National Research Foundation, South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.
African Institute for Mathematical Sciences (AIMS), Next Einstein Initiative, Kigali, Rwanda.
Elife. 2021 Jan 14;10:e42390. doi: 10.7554/eLife.42390.
Long-term effects of the growing population of HIV-treated people in Southern Africa on individuals and the public health sector at large are not yet understood. This study proposes a novel 'ratio' model that relates CD4+ T-cell counts of HIV-infected individuals to the CD4+ count reference values from healthy populations. We use mixed-effects regression to fit the model to data from 1616 children (median age 4.3 years at ART initiation) and 14,542 adults (median age 36 years at ART initiation). We found that the scaled carrying capacity, maximum CD4+ count relative to an HIV-negative individual of similar age, and baseline scaled CD4+ counts were closer to healthy values in children than in adults. Post-ART initiation, CD4+ growth rate was inversely correlated with baseline CD4+ T-cell counts, and consequently higher in adults than children. Our results highlight the impacts of age on dynamics of the immune system of healthy and HIV-infected individuals.
长期以来，人们对南部非洲接受 HIV 治疗人群的不断增长对个人和公共卫生部门的影响了解甚少。本研究提出了一种新颖的“比例”模型，该模型将 HIV 感染者的 CD4+ T 细胞计数与来自健康人群的 CD4+ 计数参考值联系起来。我们使用混合效应回归将该模型拟合到来自 1616 名儿童（ART 开始时的中位年龄为 4.3 岁）和 14542 名成人（ART 开始时的中位年龄为 36 岁）的数据。我们发现，在儿童中，与年龄相仿的 HIV 阴性个体相比，调整后的承载能力、最大 CD4+计数以及基线调整后的 CD4+计数更接近健康值。在接受 ART 治疗后，CD4+细胞增长率与基线 CD4+ T 细胞计数呈负相关，因此成人比儿童更高。我们的研究结果强调了年龄对健康个体和 HIV 感染者免疫系统动态的影响。
