摘要
目的:探讨HIV感染者自然进展的影响因素。方法:回顾性收集河南省某艾滋病高发地区1995～2016年确诊感染HIV,且未接受抗病毒治疗的感染者,选择其中的1 716例快速进展者(RPs)和379例典型进展者(TPs)作为研究对象。利用倾向性评分匹配(PSM)均衡组间协变量,基于匹配前后数据分别用非条件和条件logistic回归模型分析疾病进展的影响因素。结果:经1∶1 PSM后,成功匹配374对,匹配后协变量的标准化差异值均小于0. 1。条件logistic回归结果显示样本来自专题调查/体检和基线CD4^+T细胞计数较高的HIV感染者疾病进展较缓,OR(95%CI)分别为4. 32(2. 50～7. 47)、4. 14(3. 02～5. 67);经性传播感染、基线伴随临床症状及确诊时年龄较高的HIV感染者疾病进展较快,OR(95%CI)分别为0. 35(0. 21～0. 59)、0. 50(0. 32～0. 78)、0. 73(0. 60～0. 90)。结论:PSM可以有效均衡两组间相关混杂因素;感染途径、样本来源、基线是否伴随临床症状、确诊时年龄和基线CD4^+T细胞计数与HIV感染者的自然进展密切相关。
Aim:To explore the factors associated with natural progression among HIV-infected patients.Methods:The HIV-infected patients without antiretroviral therapy were retrospectively collected during the period of 1995-2016 in an AIDS high-incidence area of Henan Province.After selecting 1 716 rapid progressors(RPs)and 379 typical progressors(TPs)from HIV-infected patients,unconditional and conditional logistic regression analysis was fitted to analyze the association between potential factors and natural progression of HIV infection based on pre-and post-match data by propensity score matching(PSM).Results:A total of 374 pairs of patients were successfully matched by 1∶1 PSM,and the standardized difference values of all covariates were less than 0.1.The results of conditional logistic regression analysis showed that HIV-infected patients identified through unique survey/medical examination and those with higher level of CD4^+T cell counts at baseline had a slower disease progression,OR(95%CI)values were 4.32(2.50-7.47)and 4.14(3.02-5.67),respectively.HIV-infected patients transmitted through sexual transmission,those with clinical symptoms at baseline or older age at diagnosis had a faster disease progression,OR(95%CI)values were 0.35(0.21-0.59),0.50(0.32-0.78)and 0.73(0.60-0.90),respectively.Conclusion:PSM can effectively adjust for the confounders among two groups.The mode of transmission,sample sources,presenting clinical symptoms or not at baseline,age at diagnosis and CD4^+T cell counts at baseline are associated with the natural progression of HIV-infected patients.
作者
夏振华
贾晓灿
张卫萍
王曼
杨永利
施学忠
XIA Zhenhua;JIA Xiaocan;ZHANG Weiping;WANG Man;YANG Yongli;SHI Xuezhong(Department of Health Statistics,College of Public Health,Zhengzhou University,Zhengzhou 450001;Editorial Department of Journal of Zhengzhou University,Zhengzhou 450001)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2019年第3期377-381,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
国家"十三五"科技重大专项(2018ZX10715009)
关键词
HIV感染
自然进展
倾向性评分匹配
HIV infection
natural progression
propensity score matching
