Su Jinming, Liu Jie, Qin Fengxiang, Chen Rongfeng, Qin Tongxue, Tao Xing, Chen Xiu, Hong Wen, Liang Bingyu, Cui Ping, Ye Li, Jiang Junjun, Liang Hao
Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China.
Guangxi Engineering Center for Organoids and Organ-on-Chips of Highly Pathogenic Microbial Infections & Biosafety III Laboratory, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, 530021, China.
BMC Infect Dis. 2025 Jan 16;25(1):72. doi: 10.1186/s12879-025-10448-x.
The study aims to investigate the demographic characteristics, the variations in their immune status, and mortality risk among HIV-1 infection long-term non-progressors (LTNP).
Eligible LTNP and typical progressors (TP) were recruited in Guangxi by December 2018. Participants were followed up until December 2022, monitoring ART status, CD4 T cell counts, and survival/death outcomes. Multivariate logistic, Cox regression, and Kaplan-Meier method were employed to scrutinize associated factors and mortality risk of LTNP.
A total of 212 LTNP and 390 TP were included. LTNP cohort predominantly comprised males (84.43%), those diagnosed with HIV at age ≤ 40 years (93.87%), and those infected through injection drug use (59.91%). The mortality rate of LTNP were lower than TP (12.74% vs. 27.18%). TP had a higher mortality risk compared to LTNP (adjusted hazard ratio [aHR] = 4.051, 95% CI: 2.284-7.186, P < 0.001). The mortality risk was also elevated in the ART-naïve group versus the ART-experienced ones (aHR = 3.943, 95%CI: 2.658-5.850, P < 0.001). Notably, the CD4/CD8 ratio in the LTNP group did not fully recover (< 1.0) despite ART. However, LTNP with ART-experienced had a significantly lower mortality risk compared to ART-naïve LTNP group (Log-rank: P = 0.003).
ART effectively restores and maintains normal CD4 T cell levels among LTNP, thereby decreasing mortality risk. Nonetheless, the CD4/CD8 ratio in LTNP exhibits incompletely recovered post-ART. These findings provide a scientific foundation for promoting ART in LTNP population.
本研究旨在调查人类免疫缺陷病毒1型（HIV-1）感染长期不进展者（LTNP）的人口统计学特征、免疫状态变化及死亡风险。
截至2018年12月，在广西招募符合条件的LTNP和典型进展者（TP）。对参与者进行随访至2022年12月，监测抗逆转录病毒治疗（ART）状态、CD4 T细胞计数及生存/死亡结局。采用多因素逻辑回归、Cox回归及Kaplan-Meier方法分析LTNP的相关因素及死亡风险。
共纳入212例LTNP和390例TP。LTNP队列主要为男性（84.43%），年龄≤40岁时诊断为HIV者（93.87%），以及通过注射吸毒感染的患者（59.91%）。LTNP的死亡率低于TP（12.74%对27.18%）。与LTNP相比，TP的死亡风险更高（调整后风险比[aHR]=4.051，95%置信区间：2.284-7.186，P<0.001）。未接受ART组的死亡风险也高于接受过ART的组（aHR=3.943，95%置信区间：2.658-5.850，P<0.001）。值得注意的是，尽管接受了ART，LTNP组的CD4/CD8比值仍未完全恢复（<1.0）。然而，与未接受过ART的LTNP组相比，接受过ART的LTNP的死亡风险显著降低（对数秩检验：P=0.003）。
ART能有效恢复并维持LTNP的正常CD4 T细胞水平，从而降低死亡风险。尽管如此，LTNP的CD4/CD8比值在ART后未完全恢复。这些发现为在LTNP人群中推广ART提供了科学依据。
