Public Health School, Xinjiang Medical University, Urumqi, 830011, Xinjiang, China.
STD/HIV Prevention and Control Center, Xinjiang Uighur Autonomous Region Center for Disease Control and Prevention, Urumqi, 830002, Xinjiang, China.
AIDS Behav. 2024 Sep;28(9):3151-3160. doi: 10.1007/s10461-024-04396-x. Epub 2024 Jun 13.
This 12-year cohort study of 80 long-term non-progressors (LTNPs) observed a cumulative follow-up duration of 628.5 person-years. Among them, 60 received antiretroviral therapy (ART) for a total of 418.6 person-years. Twenty-four deaths occurred during the follow-up period, with an average age of 42.36 years and a lowest 8-year survival rate of 0.90. Cox model analysis revealed that the risk of AIDS-related death was 1.47 times higher for non-marital, non-commercial heterosexual transmission than for injection drug use. Treatment initiation at ages 31-40 was correlated with an elevated risk of mortality, while treatment for 3-10 years reduced mortality risks in untreated LTNPs. Flow cytometry observed significant differences in the proportion of NK cells. Long-term ART (> 2 years) before LTNPs developed AIDS symptoms could lower mortality risk and potentially extend lifespan, especially when it was initiated at a younger age without affecting NK cell balance. Epidemiological and immunological studies on ART-treated LTNPs are vital for advancing HIV treatment and achieving functional cures for AIDS individuals.
本研究对 80 名长期非进展者(LTNPs)进行了 12 年的队列研究,观察到累积随访时间为 628.5 人年。其中 60 人接受了抗逆转录病毒治疗(ART),总共有 418.6 人年。在随访期间发生了 24 例死亡,平均年龄为 42.36 岁,最低 8 年生存率为 0.90。Cox 模型分析表明,非婚姻、非商业异性传播的艾滋病相关死亡风险是非注射吸毒者的 1.47 倍。31-40 岁开始治疗与死亡率升高相关,而在未治疗的 LTNPs 中,治疗 3-10 年可降低死亡率。流式细胞术观察到 NK 细胞比例有显著差异。在出现艾滋病症状之前,LTNPs 接受长期 ART(>2 年)治疗可以降低死亡率风险,并可能延长寿命,特别是在不影响 NK 细胞平衡的情况下,在较年轻的时候开始治疗。对接受 ART 治疗的 LTNPs 的流行病学和免疫学研究对于推进 HIV 治疗和实现艾滋病个体的功能性治愈至关重要。