Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Neurology, Cheng Du Shang Jin Nan Fu Hospital, Chengdu, Sichuan, China.
Int Immunopharmacol. 2022 Nov;112:109192. doi: 10.1016/j.intimp.2022.109192. Epub 2022 Sep 22.
To compare the efficacy of intravenous immunoglobulin (IVIG) added to antiretroviral therapy (ART) and ART alone in people living with human immunodeficiency virus-associated Guillain-Barré syndrome (HIV-associated GBS).
The study was a retrospective analysis of clinical records of HIV-associated GBS patients from department of neurology at West China Hospital between January 2015 and October 2020. Patients treated with ART alone were compared with those treated with IVIG + ART. The primary outcome was the GBS disability score at 4 weeks, which was assessed with multivariable ordinal regression. Additional outcomes include the GBS disability scale at 1 week, improvement of ≥ 1 point on the GBS disability score at 1 and 4 weeks, median change in the MRC sum score at 1 and 4 weeks, number of patients who were able to walk independently at 4 weeks.
Two hundred and fifty-two (252) individuals living with HIV were recruited in the study. According to the inclusion and exclusion criteria, 21 HIV-associated GBS patients were finally included, of whom 8 were treated with IVIG + ART and 13 were treated with ART alone. At the fourth weeks after treatment, the GBS disability scale grade was significantly lower in patients treated with IVIG + ART than those with ART alone (1 vs. 2, P = 0.02). The adjusted OR for a lower GBS disability scale was 10.6 (95 % CI 1.15 to 98.05; P = 0.03) for the IVIG + ART group. Moreover, 6 of 8 (75 %) patients treated with IVIG + ART were able to walk independently at four weeks after treatment.
The introduction of IVIG combined with ART may be efficacious in the treatment of HIV-infected GBS and may provide better clinical outcomes.
比较静脉注射免疫球蛋白（IVIG）联合抗逆转录病毒治疗（ART）与单独 ART 治疗人类免疫缺陷病毒相关性格林-巴利综合征（HIV 相关性 GBS）患者的疗效。
这是一项对 2015 年 1 月至 2020 年 10 月期间在华西医院神经内科就诊的 HIV 相关性 GBS 患者的临床记录进行的回顾性分析。将单独接受 ART 治疗的患者与接受 IVIG+ART 治疗的患者进行比较。主要结局为 4 周时的 GBS 残疾评分，采用多变量有序回归进行评估。其他结局包括 1 周时的 GBS 残疾量表、1 周和 4 周时 GBS 残疾评分提高≥1 分、1 周和 4 周时 MRC 总和评分的中位数变化、4 周时能够独立行走的患者人数。
本研究共纳入 252 名 HIV 感染者。根据纳入和排除标准，最终纳入 21 名 HIV 相关性 GBS 患者，其中 8 名接受 IVIG+ART 治疗，13 名接受单独 ART 治疗。治疗后第 4 周，IVIG+ART 治疗组患者的 GBS 残疾量表评分明显低于单独 ART 治疗组（1 分比 2 分，P=0.02）。IVIG+ART 组的 GBS 残疾量表评分较低的调整比值比（OR）为 10.6（95%CI 1.15 至 98.05；P=0.03）。此外，8 名接受 IVIG+ART 治疗的患者中有 6 名（75%）在治疗后第 4 周能够独立行走。
IVIG 联合 ART 的应用可能对 HIV 感染性 GBS 有效，并可能提供更好的临床结局。
