摘要
目的旨在了解保定市2005-2020年的艾滋病感染者接受抗逆转录病毒治疗(anti-retroviruses therapy,ART)后免疫学效果及其影响因素。方法通过对“全国艾滋病防治基本信息系统”的数据进行筛选,采用回顾性研究,使用卡方检验和多因素Logistic回归方法分析影响艾滋病患者抗逆转录病毒治疗免疫学效果的因素。结果经筛选共2354例病例被纳入本研究,其中免疫学有效组1836例(77.99%)、免疫学失败组518例(22.01%),免疫学有效组治疗后较治疗前CD4^(+)T淋巴细胞数量明显升高(P<0.05),免疫学失败组CD4^(+)T淋巴细胞数量治疗前后差异无统计学意义(P>0.05)。经多因素Logistic回归分析,51~65岁(OR=1.33,95%CI:1.01~1.74)和≥66岁(OR=1.63,95%CI:1.09~2.46),WHO临床分期Ⅱ期(OR=1.38,95%CI:1.01~1.87)、Ⅲ期(OR=2.70,95%CI:1.18~4.00)和Ⅳ期(OR=2.41,95%CI:1.54~3.78),服药依从性不良(OR=4.00,95%CI:2.25~7.14),病毒学失败(OR=5.06,95%CI:3.02~8.49)可以增加免疫学失败发生的风险(P<0.05)。治疗年限2~5年(OR=0.51,95%CI:0.39~0.67)和>5年(OR=0.34,95%CI:0.25~0.46),接受过复方新诺明预防治疗(OR=0.36,95%CI:0.26~0.50)可以降低免疫学失败发生的风险(P<0.05)。结论早期发现、早治疗、提高服药依从性、减少病毒学失败等措施能降低抗逆转录病毒治疗免疫学失败的发生。
Objective To assess the immunological effect of antiretroviral therapy(ART) and related risk factors in Baoding, 2005-2020.Methods A retrospective cohort study was conducted in this work. The influencing factors of ART were confirmed via the chi-square test and multi-factor logistic regression analysis.Results A total of 2 354 cases were included in the study. Of them, 518 cases(22.01%) had the immunological failure. The count of CD4+T lymphocytes in the immunological failure group showed no difference before and after ART(P>0.05). Multivariate Logistic regression analysis showed that age 51-65(OR=1.33, 95%CI:1.01-1.74) and ≥ 66(OR=1.63, 95%CI:1.09-2.46), WHO clinical stage Ⅱ(OR=1.38, 95%CI:1.01-1.87), Ⅲ(OR=2.70, 95%CI:1.18-4.00) and Ⅳ(OR=2.41, 95%CI:1.54-3.78), poor adherence to ART(OR=4.00, 95%CI:2.25-7.14), and virologic failure(OR=5.06, 95%CI: 3.02-8.49) could elevate the risk of immunological failure(P<0.05). Duration of treatment 2-5 years(OR=0.51, 95%CI:0.39-0.67) and >5 years(OR=0.34, 95%CI:0.25-0.46), and cotrimoxazole prophylaxis(OR=0.36, 95%CI:0.26-0.50) could reduce the risk of immunological failure(P<0.05).Conclusion The early detection, the early treatment, the better medication adherence, and the reduction of virologic failure can decrease the occurrence of immunological failure.
作者
李永勤
杨学刚
粱叶
刘洋
赵静
路新利
LI Yongqin;YANG Xuegang;LIANG Ye;LIU Yang;ZHAO Jing;LU Xinli(Clinical Laboratory,the People's Hospital of Baoding,Baoding 071000,China;Infection Division,the People's Hospital of Baoding,Baoding 071000,China;Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang 050021,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2023年第2期196-201,共6页
The Chinese Journal of Dermatovenereology
基金
河北省自然科学基金(H2016303006)
保定市科技计划项目(2041ZF150)。
关键词
艾滋病
抗病毒治疗
免疫学失败
影响因素
AIDS
Antiretroviral therapy
Immunological failure
Risk factors
