分析不同亚型 HIV/AIDS 患者抗病毒治疗的免疫反应：一项回顾性队列研究。

Analysis of the immunological response to antiviral therapy in patients with different subtypes of HIV/AIDS: a retrospective cohort study.

机构信息

Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China.

Division of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

BMJ Open. 2024 May 15;14(5):e072597. doi: 10.1136/bmjopen-2023-072597.

DOI:10.1136/bmjopen-2023-072597

PMID:38749684

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11097878/

Abstract

OBJECTIVE

To evaluate the effectiveness of standardised antiretroviral therapy (ART) among different HIV subtypes in people living with HIV/AIDS (PLWHA), and to screen the best ART regimen for this patient population.

DESIGN

A retrospective cohort study was performed, and PLWHA residing in Huzhou, China, between 2018 and 2020, were enrolled.

SETTING AND PARTICIPANTS

Data from 625 patients, who were newly diagnosed with HIV/AIDS in the AIDS Prevention and Control Information System in Huzhou between 2018 and 2020, were reviewed.

ANALYSIS AND OUTCOME MEASURES

Data regarding demographic characteristics and laboratory investigation results were collected. Immune system recovery was used to assess the effectiveness of ART, and an increased percentage of CD4 T lymphocyte counts >30% after receiving ART for >1 year was determined as immunopositive. A multiple logistic regression model was used to comprehensively quantify the association between PLWHA immunological response status and virus subtype. In addition, the joint association between different subtypes and treatment regimens on immunological response status was investigated.

RESULTS

Among 326 enrolled PLWHA with circulating recombinant forms (CRFs) CRF01_AE, CRF07_BC and other HIV/AIDS subtypes, the percentages of immunopositivity were 74.0%, 65.6% and 69.6%, respectively. According to multivariate logistic regression models, there was no difference in the immunological response between patients with CRF01_AE, CRF07_BC and other subtypes of HIV/AIDS who underwent ART (CRF07_BC: adjusted OR (aOR) (95% CI) = 0.8 (0.4 to 1.4); other subtypes: aOR (95% CI) = 1.2 (0.6 to 2.3)). There was no evidence of an obvious joint association between HIV subtypes and ART regimens on immunological response.

CONCLUSIONS

Standardised ART was beneficial to all PLWHA, regardless of HIV subtypes, although it was more effective, to some extent, in PLWHA with CRF01_AE.

摘要

目的

评估标准化抗逆转录病毒疗法（ART）在不同 HIV 亚型的 HIV/AIDS 患者（PLWHA）中的有效性，并为该患者人群筛选最佳的 ART 方案。

设计

进行了一项回顾性队列研究，纳入 2018 年至 2020 年期间居住在浙江省湖州市的 PLWHA。

地点和参与者

回顾了 2018 年至 2020 年期间在湖州市艾滋病防治信息系统中新诊断为 HIV/AIDS 的 625 例患者的数据。

分析和结果

收集了人口统计学特征和实验室检查结果的数据。使用免疫系统恢复来评估 ART 的有效性，并确定接受 ART 治疗超过 1 年后 CD4+T 淋巴细胞计数增加 >30%为免疫阳性。采用多因素逻辑回归模型综合量化 PLWHA 免疫反应状态与病毒亚型之间的关系。此外，还研究了不同亚型和治疗方案对免疫反应状态的联合关联。

结果

在纳入的 326 例具有循环重组形式（CRF）CRF01_AE、CRF07_BC 和其他 HIV/AIDS 亚型的 PLWHA 中，免疫阳性率分别为 74.0%、65.6%和 69.6%。根据多因素逻辑回归模型，接受 ART 的 CRF01_AE、CRF07_BC 和其他 HIV/AIDS 亚型患者的免疫反应无差异（CRF07_BC：调整后的比值比（aOR）（95%CI）=0.8（0.4 至 1.4）；其他亚型：aOR（95%CI）=1.2（0.6 至 2.3））。没有证据表明 HIV 亚型和 ART 方案在免疫反应上存在明显的联合关联。