Fan Lina, Li Penghui, Yu Aiping, Liu Dan, Wang Ziyu, Wu Yue, Zhang Defa, Zou Meiyin, Ma Ping
Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China.
Department of Surgery, Tianjin Second People's Hospital, Tianjin, China.
Front Med (Lausanne). 2023 Oct 19;10:1259871. doi: 10.3389/fmed.2023.1259871. eCollection 2023.
Antiretroviral therapy (ART) prolongs lifespan and decreases mortality of HIV infected patients. However, many patients do not achieve optimal immune reconstitution. The influence of non-optimal immune recovery on non-AIDS related diseases is not well defined in aged HIV-infected patients receiving ART.
A retrospective study was conducted at Tianjin Second People's Hospital, China to evaluate the association of an inadequate immunological response and non-AIDS diseases in HIV infected patients ≥60 years of age and virally suppressed for at least 2 years by ART.
The study included patients ( = 666) who initiated ART between August 2009 and December 2020. The prevalence of patients with an inadequate immunological response was 29.6%. The percentage of non-AIDS diseases such as hypertension, cardiovascular disease (CVD), diabetes, tumor, and chronic kidney disease (CKD) was 32.9, 9.9, 31, 4.1, and 13%, respectively. In addition to baseline CD4+ T cell counts, CVD and tumor were associated with poor immune reconstitution in aged Chinese HIV-1 infected patients. The adjusted odds ratios (95% confidence interval) were AOR 2.45 (95% CI: 1.22-4.93) and 3.06 (95% CI: 1.09-8.56, = 0.03). Inadequate immunological response was associated with greater mortality (AOR: 2.83, 95% CI: 1.42-5.67, = 0.003) in this cohort.
These results tend to demonstrate appropriate drug selection at ART initiation and prevention of non-AIDS complications during ART decreased mortality of and an inadequate immunological response in aged HIV infected patients.
抗逆转录病毒疗法（ART）可延长HIV感染患者的寿命并降低其死亡率。然而，许多患者并未实现最佳的免疫重建。在接受ART的老年HIV感染患者中，非最佳免疫恢复对非艾滋病相关疾病的影响尚不明确。
在中国天津市第二人民医院进行了一项回顾性研究，以评估年龄≥60岁且通过ART病毒抑制至少2年的HIV感染患者中免疫反应不足与非艾滋病疾病之间的关联。
该研究纳入了2009年8月至2020年12月期间开始接受ART的患者（n = 666）。免疫反应不足患者的患病率为29.6%。高血压、心血管疾病（CVD）、糖尿病、肿瘤和慢性肾脏病（CKD）等非艾滋病疾病的百分比分别为32.9%、9.9%、31%、4.1%和13%。除了基线CD4 + T细胞计数外，CVD和肿瘤与中国老年HIV-1感染患者免疫重建不良有关。调整后的优势比（95%置信区间）分别为AOR 2.45（95% CI：1.22 - 4.93）和3.06（95% CI：1.09 - 8.56，P = 0.03）。在该队列中，免疫反应不足与更高的死亡率相关（AOR：2.83，95% CI：1.42 - 5.67，P = 0.003）。
这些结果倾向于表明，在ART起始时选择合适的药物以及在ART期间预防非艾滋病并发症可降低老年HIV感染患者的死亡率和免疫反应不足的情况。
