在四个非洲国家的观察队列中,持久的低水平病毒病与非传染性并发症有关
Allahna L Esber1,2, Suze Colt1,2, Ningbo Jian1,2
1U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Journal of the International AIDS Society
|August 27, 2024
概括
艾滋病毒感染者 (PLWH) 的持续低水平病毒性血清 (pLLV) 与非传染性并发性疾病 (NCD) 的更高风险有关. 管理LLV可能会改善PLWH中NCD的结果.
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:
- 艾滋病毒感染者 (PLWH) 患非传染性并发性疾病 (NCD) 的比率更高.
- 非洲队列研究 (AFRICOS) 调查了PLWH中非传染性疾病风险,检测不到的病毒载荷与持续的低水平病毒性病 (pLLV) 相比.
- 此外,还研究了免疫激活在LLV-NCD关联中的作用.
研究的目的:
- 与pLLV患者相比,与无法检测的病毒载荷相比,在PLWH患者中描述NCD风险.
- 量化免疫激活对LLV和NCDs之间的关系的影响.
主要方法:
- 分析了来自乌干达,肯尼亚,坦桑尼亚和尼日利亚12家诊所的AFRICOS队列数据.
- 包括接受抗逆转录病毒疗法的参与者,长达6个月以上,没有先前存在的非传染性疾病.
- 定义pLLV为≥2次连续访问,病毒载量<1000副本/毫升;评估高血压,高胆固醇,高血糖,功能不全和复合NCD.
- 使用Cox比例危险建模和生物标记分析来评估相互作用.
主要成果:
- 在2013年1月至2022年12月期间,分析了1755名参与者.
- 与那些病毒载量无法检测的参与者相比,pLLV的参与者出现任何非传染性疾病的发病率增加 (aHR:1.22,95% CI:1.02-1.47).
- 在LLV和TNF-α,CCL2/MCP-1和TNF-RII之间发现了与NCD发展有关的显著相互作用.
结论:
- 持久的低水平病毒血症与PLWH中NCD风险增加和免疫炎症显著相关.
- 对LLV的积极管理可能会导致艾滋病毒感染者改善NCD的结果.
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