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中国新疆地区 HIV 长期非进展者的生存分析及免疫差异:一项为期 12 年的前瞻性队列观察。

Survival Analysis and Immune Differences of HIV Long-Term Non-progressors in Xinjiang China: A 12-Year Prospective Cohort Observation.

机构信息

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.

出版信息

AIDS Behav. 2024 Sep;28(9):3151-3160. doi: 10.1007/s10461-024-04396-x. Epub 2024 Jun 13.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7981/11390762/b83088a653ae/10461_2024_4396_Fig1_HTML.jpg

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