在ART启动后与免疫不响应相关的因素:一项追溯观察队列研究
Heping Zhao1,2, Anping Feng2, Dan Luo2
1Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
BMC infectious diseases
|January 29, 2024
概括
接受抗逆转录病毒疗法 (ART) 的艾滋病毒感染者 (PLHIV) 免疫不响应与男性性别,年龄较大和并发感染有关. 基于蛋白酶抑制剂的疗法可以提供保护,防止不响应.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 接受抗逆转录病毒治疗 (ART) 的艾滋病毒感染者 (PLHIV) 死亡率较高,如果他们是免疫不响应者 (INR).
- 尽管有ART,但导致免疫不响应的因素尚不清楚.
研究的目的:
- 在接受ART的HIV患者中识别与免疫不响应相关的因素.
- 研究不同ART疗法对免疫反应的影响.
主要方法:
- 分析了来自中国国家免费抗逆转录病毒治疗计划的3900个PLHIV的数据.
- 根据ART治疗24个月后的CD4计数,患者被分为免疫反应者 (IR),不完全反应者 (ICR) 和INR.
- 使用多变量逻辑回归来确定与免疫不响应相关的因素.
主要成果:
- 该研究确定了9.9%的免疫不响应 (INR) 率.
- 独立的INR风险因素包括男性性别,年龄较大,HBV/HCV联合感染,较低的基线CD4+T细胞计数和较低的CD4/CD8比率.
- 基于蛋白酶抑制剂 (PI) 的ART疗法与基于非核酸逆转录酶抑制剂 (NNRTI) 的疗法相比,INR的可能性较低.
结论:
- 在接受ART治疗的HIV患者中,很大一部分患者表现出免疫不响应.
- 男性的性别,老年,病毒性肝炎的共同感染,以及较低的基线免疫细胞计数是免疫学结果差的危险因素.
- 基于PI的ART疗法似乎是PLHIV免疫不响应的保护因素.
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