两门定义的免疫不响应者与艾滋病患者的长期发病率有关:一项前性队列研究
Xiaorui Li1, Liqin Sun2, Yun He2
1School of Public Health, Shenzhen University Medical School, Shenzhen, People's Republic of China.
Emerging microbes & infections
|August 8, 2025
概括
尽管接受抗逆转录病毒疗法 (ART),但未能实现完全免疫恢复的艾滋病毒感染者 (PWH) 面临更高的严重疾病风险. 免疫不响应者 (INRs) 与艾滋病定义和非艾滋病定义条件的发病率增加有关,这强调了需要更好的监测.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 许多接受抗逆转录病毒治疗 (ART) 的艾滋病毒感染者 (PWH) 无法完全恢复免疫力.
- 这种不完全的免疫恢复,称为免疫不响应 (INR),可能会增加严重并发病的风险.
研究的目的:
- 调查免疫不响应者 (INR) 状态与艾滋病定义疾病 (AD) 和非艾滋病定义疾病 (NAD) 的发病率之间的联系.
- 评估艾滋病毒感染者未能达到充足的CD4+T细胞恢复的长期健康结果.
主要方法:
- 一项前性队列研究,涉及7,874名 (低值) 和8,077名 (高值) 艾滋病毒感染者.
- 免疫不响应 (INR) 被定义为在两个连续测量时未能达到CD4+T细胞值 (350或500细胞/μL).
- 卡普兰-梅尔曲线和考克斯比例危险模型被用来分析INR和疾病发病率之间的关联.
主要成果:
- 在低值队列中,INR独立地与AD的显著增加风险相关 (例如,肺囊肺炎,塔拉罗米病,艾滋病定义癌症) 和NAD (例如,末期肝病,心血管疾病,慢性病,非艾滋病定义癌症).
- 在高值队列中也观察到类似的显著关联.
- 免疫不响应 (INR) 显示出与艾滋病毒感染者 (PWH) 的长期发病率有很强的联系.
结论:
- 免疫不响应 (INR) 是艾滋病定义疾病和非艾滋病定义疾病的重要危险因素,在艾滋病病毒感染者 (PWH) 接受ART.
- 目前的CD4+T细胞监测可能不足以充分评估PWH的长期疾病风险.
- 需要加强超出CD4+T细胞计数的风险评估策略,以减轻PWH的疾病负担.
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