[1]董文斌,赵金仙,李世福,等.未抗病毒治疗的HIV/AIDS患者 CD4+T淋巴细胞快速下降和显著下降比例及相关因素[J].中国皮肤性病学杂志,2018,(05):529-535.[doi:10.13735/j.cjdv.1001-7089.201709030]
 DONG Wenbin,ZHAO Jinxian,LI Shifu,et al.Proportion of Rapid and Significant Decline of CD4+T Cell Counts Among Antiretroviral Treatment-naive HIV/AIDS Patients and Related Influencing Factors[J].The Chinese Journal of Dermatovenereology,2018,(05):529-535.[doi:10.13735/j.cjdv.1001-7089.201709030]
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未抗病毒治疗的HIV/AIDS患者 CD4+T淋巴细胞快速下降和显著下降比例及相关因素
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2018年05期
页码:
529-535
栏目:
性传播疾病
出版日期:
2018-05-01

文章信息/Info

Title:
Proportion of Rapid and Significant Decline of CD4+T Cell Counts Among Antiretroviral Treatment-naive HIV/AIDS Patients and Related Influencing Factors
作者:
董文斌赵金仙李世福陈黎跃蔡英许杰鲁建波李顺祥
云南省玉溪市疾病预防控制中心,云南 玉溪 653100
Author(s):
DONG Wenbin ZHAO Jinxian LI Shifu CHEN Liyue CAI Ying XU Jie LU JianboLI Shunxiang
Yuxi Centre for Disease Control and Prevention, Yuxi 653100, China
关键词:
HIV CD4+T淋巴细胞 快速下降 显著下降 影响因素
Keywords:
HIV CD4+T lymphocyte Rapid decline Significant decline Influential factors
分类号:
R 512.91
DOI:
10.13735/j.cjdv.1001-7089.201709030
文献标志码:
B
摘要:
目的 探讨云南省玉溪市新报告的艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS)在未抗病毒治疗的情况下其CD4+T值快速下降及显著下降情况,分析其相关因素。 方法 收集未抗病毒治疗HIV/AIDS历次CD4+T淋巴细胞计数值、人口学特征、样本来源和可能感染途径等,计算快速下降率和显著下降率并分析相关因素。结果 1 480例HIV/AIDS其CD4+T值快速下降率和显著下降率分别为42.64%(631/1 480)、52.23%(773/1 480),单因素分析结果显示,CD4+T值快速下降与性别、文化、年龄、职业、婚姻状况、传播途径、首次CD4+T值以及首末次检测时间间隔有关,CD4+T值显著下降与文化、民族、传播途径、首次CD4+T值以及首末次检测时间间隔有关; 经多因素Logistic回归分析表明,女性(OR=1.271,95%CI: 1.044~1.674)、已婚(OR=1.460,95%CI:1.093~1.949)、传播途径注射吸毒(OR=1.365,95%CI:1.016~1.833)、首次CD4+T值> 500 cell/μL,更容易出现CD4+T值快速下降,首末次检测时间间隔> 18个月更不容易出现CD4+T值快速下降; 传播途径注射吸毒(OR=1.286,95%CI:1.018~1.625)、首次CD4+T值> 500 cell/μL、首末次检测时间间隔≥ 6个月,更容易出现CD4+T值显著下降,传播途径为男男性行为(OR=0.426,95%CI:0.199~0.914)更不容易出现CD4+T值显著下降。 结论 HIV/AIDS患者CD4+T值快速下降和显著下降与性别、婚姻状况、传播途径等因素有关,需加强对女性、已婚、注射吸毒人群的定期随访,及时启动抗病毒治疗。
Abstract:
Objective To examine the proportion of rapid and significant decline of CD4+T cell counts and related influencing factors among antiretroviral treatment(ART)-naive HIV/AIDS patients newly reported in Yuxi, Yunnan. Methods The information of ART-naive HIV/AIDS patients including all previous CD4+T cell counts, demographic characteristics, sample source and potential route of HIV transmission were collected, and the rates of rapid and significant CD4+T decline were counted, and the related factors were statistically analyzed. Results The rates of rapid and significant CD4+T decline were 42.64%(631/1 480)and 52.23%(773/1 480)respectively. Univariate logistic regression analyses indicated that rapid decline of CD4+T cell counts were associated with gender, education, age, occupation, marital status, route of HIV infection, baseline CD4+T cell counts, and interval between first and last CD4+T testing, whereas the significant decline of CD4+T cell counts were associated with education, ethnicity, route of HIV infection, baseline CD4+T cell counts, and interval between first and last CD4+T testing. Multivariate logistic regression analyses indicated that females(OR=1.271, 95%CI: 1.044~1.674), being married(OR=1.460, 95%CI: 1.093~1.949), HIV transmitted through injected drug use(OR=1.365, 95%CI: 1.016~1.833), initial CD4+T cell counts > 500 cell/μL were more likely to lead to a rapid CD4+T decline, whereas interval between first and last CD4+T testing > 18 months was less likely to result in a rapid CD4+T decline; HIV transmitted through injected drug use(OR=1.286, 95%CI:1.018~1.625), initial CD4+T cell counts > 500 cell/μL,and interval between first and last CD4+T testing > 6 months were more likely to contribute to a significant CD4+T decline, whereas male-to-male contact(OR=0.426, 95%CI: 0.199~0.914)were less likely to witness a significant CD4+T decline. Conclusion Gender, marital status, route of HIV infection were associated with rapid decline and significant decline of CD4+T cell counts. Therefore, it is important to strengthen the regular follow-up for those being female, married, transmitted through injected drug use and to initiate ART timely.

参考文献/References:

[1] Maduna PH, Dolan M, Kondlo L, et al. Morbidity and mortality according to latest CD4+ cell count among HIV positive individuals in South Africa who enrolled in project Phidisa[J]. Plos One, 2014, 10(4):e0121843.
[2] Zhang F, Dou Z, Ma Y, et al. Effect of earlier initiation of antiretroviral treatment and increased treatment coverage on HIV-related mortality in China: a national observational cohort study[J]. Lancet Infect Dis, 2011, 11(7):516-524.
[3] 胡芳琴, 吴勇, 张展,等. 不同CD4+基线值艾滋病患者高效抗逆转录病毒治疗后免疫重建效果观察[J]. 中华医院感染学杂志, 2015, 25(24):5521-5523.
[4] Audigé A, Taff P, Rickenbach M, et al. 210 Low Post-Seroconversion CD4 count and rapid decrease of CD4 density identify HIV+ fast progressors[J]. AIDS Res Hum Retroviruses, 2010, 26(9):997-1005.
[5] Musumeci G, Magnani G, Bon I, et al. HIV-1 early and late diagnosis in the Emilia Romagna Region(Italy): a three-year study[J].New Microbiol, 2016, 39(4):241-246.
[6] 叶润华, 段松, 项丽芬,等. 云南省德宏州无抗病毒治疗史的HIV感染者CD4+T淋巴细胞计数自然变化及其影响因素[J]. 中华流行病学杂志, 2011, 32(9):882-887.
[7] 于茂河, 郭燕, 宁铁林,等. 天津市未接受抗病毒治疗HIV/AIDS病例CD4+T淋巴细胞计数变化情况及影响因素[J]. 中国艾滋病性病, 2015,21(9):753-756.
[8] 李世福,高良敏,蔡英,等. 未治疗HIV/AIDS中CD4+T淋巴细胞计数与机会性感染的相关性分析[J]. 中国皮肤性病学杂志,2017,31(3):28-33.
[9] Wang L, Ge L, Wang L, et al. Causes of death among AIDS patients after introduction of free combination antiretroviral therapy(cART)in three Chinese provinces, 2010-2011[J]. Plos One, 2015, 10(10):e0139998.
[10] 谢年华, 江洪波, 许骏,等. 武汉市HIV/AIDS未治疗患者生存质量及影响因素研究[J]. 中华疾病控制杂志, 2015, 19(12):1204-1207.
[11] Manolescu L, Marinescu P. Sex differences in HIV-1 viral load and absolute CD4 cell count in long term survivors HIV-1 infected patients from Giurgiu, Romania[J]. Romanian Review of Laboratory Medicine, 2013, 21(2-4):217-224.
[12] Maskew M, Brennan AT, Westreich D, et al. Gender differences in mortality and CD4 count response among virally suppressed HIV-positive patients[J]. J Womens Health, 2013, 22(22):113-120.
[13] 琚腊红, 吕繁, 徐鹏,等. 从性别视角分析HIV感染者和艾滋病患者自我歧视状况及其影响因素[J]. 中华预防医学杂志, 2016, 50(10):863-868.
[14] 杨世江, 段松, 项丽芬,等. 云南省德宏州HIV感染者中病情长期不进展者所占比例及其影响因素[J]. 中华疾病控制杂志, 2012, 16(12):1049-1051.
[15] 刘小春, 李再友, 付金翠,等. 2006~2013年玉溪市报告HIV感染者/AIDS病例双阳家庭及单阳家庭阳转状况分析[J]. 预防医学论坛, 2015,21(5):354-356.
[16] 齐金蕾, 罗红兵, 马艳玲,等. 云南省家庭内配偶经性传播HIV影响因素调查[J]. 中华流行病学杂志, 2012, 33(2):173-176.
[17] 李世福, 许杰, 蔡英,等. 两种检测方法评估玉溪市较早发现HIV感染者的效率[J]. 中国皮肤性病学杂志, 2013,27(9):910-912.
[18] Meijerink H, Wisaksana R, Iskandar S, et al. Injecting drug use is associated with a more rapid CD4 cell decline among treatment naïve HIV-positive patients in Indonesia[J].J Int AIDS Soc, 2014, 17(1):18844-18851.
[19] 李世福, 付金翠, 李再友,等. 静脉注射吸毒人群 HIV/HCV 混合感染者与 HIV 单独感染者艾滋病疾病进展比较分析[J]. 中华微生物学和免疫学杂志, 2015,35(9):692-697.
[20] Zhang F, Zhu H, Wu Y, et al. HIV, hepatitis B virus, and hepatitis C virus co-infection in patients in the China National Free Antiretroviral Treatment Program, 2010-12: a retrospective observational cohort study[J].Lancet Infect Dis, 2014, 14(11):1065-1072.

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备注/Memo

备注/Memo:
[基金项目] 科技人才引进与培养专项(云南省中青年学术和技术带头人后备人才、云南省技术创新人才培养对象,2016HB052)
[通讯作者] 李顺祥,E-mail: 791611849@qq.com
更新日期/Last Update: 2018-05-01