延迟艾滋病毒诊断和治疗对晚年痴呆风险的影响
Jennifer O Lam1,2, Catherine Lee3, Craig E Hou4
1Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA.
Open forum infectious diseases
|January 26, 2026
概括
在抗逆转录病毒疗法 (ART) 之前的低CD4计数表明,HIV治疗延迟与HIV成年人痴呆风险增加有关. 及时启动ART对长期认知健康至关重要.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 老年学是指老年学的学科.
背景情况:
- 人类免疫缺陷病毒 (HIV) 的延迟诊断和治疗可能会增加晚年发展痴呆症的风险.
- 在开始抗逆转录病毒疗法 (ART) 之前 CD4 T 细胞数量较低,可以作为延迟艾滋病毒诊断或治疗的代理.
研究的目的:
- 评估在艾滋病毒感染的成年人中较低的前ARTCD4计数和与年龄相关的痴呆症风险之间的关联.
- 调查ART启动后CD4计数恢复对痴呆风险的影响.
主要方法:
- 从2000年到2023年,对美国艾滋病毒感染年龄≥50岁的成年人进行了回顾性队列研究.
- 暴露:低的ART前CD4计数 (<200细胞/μL). 结果:通过电子健康记录诊断痴呆症.
- 使用了细灰分区危险模型,考虑了死亡的竞争风险,并调整了混因素.
主要成果:
- 在21,354名参与者中,30%的患者在ART前的CD4计数<200细胞/μL.
- 低的ART前CD4计数与明显增加的痴呆风险有关 (aHR:1.33,95%CI:1.13-1.57).
- 在ART治疗后CD4恢复到≥500细胞/μL减轻了痴呆风险,但没有消除它 (aHR:1.17,95%CI:0.85-1.60).
结论:
- 在ART开始前CD4数量较低,反映出HIV诊断或治疗延迟,与痴呆风险增加有关.
- 积极的艾滋病毒查和及时的ART启动对于支持艾滋病毒感染者的长期认知健康至关重要.
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