河北省唐山市无抗病毒治疗史HIV感染者CD_4^+T淋巴细胞计数自然变化研究

Study on the natural variation of CD_4^+T cell counts of antiretroviral treatment-native HIV-infected patients in Tangshan City of Hebei Province

目的了解无抗病毒治疗史HIV感染者CD_4^+T淋巴细胞计数自然变化速率及其影响因素。方法对唐山市2015年12月31日前未接受抗病毒治疗或接受抗病毒治疗前至少有两次CD_4^+T淋巴细胞计数检测的HIV感染者的一般特征、首末次CD_4^+T淋巴细胞计数和首末次检测间隔进行分析,描述CD_4^+T淋巴细胞计数自然变化速率,用logistic回归模型分析CD_4^+T淋巴细胞计数显著下降的影响因素。结果共纳入HIV感染者376例,CD_4^+T淋巴细胞计数月均自然变化速率M=-3.5(IQR:-10.2~2.2);66.8%(251/376)的HIV感染者CD_4^+T淋巴细胞计数结果低于首次;31.4%(118/376)的HIV感染者CD_4^+T淋巴细胞计数显著下降。多因素logistic回归分析结果显示,HIV感染者CD_4^+T淋巴细胞计数显著下降,与性别、首次CD_4^+T淋巴细胞计数水平和首末次检测间隔存在关联。结论唐山市HIV感染者CD_4^+T淋巴细胞计数自然变化速率总体平缓,部分HIV感染者CD_4^+T淋巴细胞计数显著下降与多种因素有关。应加强HIV感染者随访管理,密切监测CD_4^+T淋巴细胞计数水平和变化速率,适时启动抗病毒治疗。

Objective To understand the natural variation rate and influencing factors of CD4 T cell counts of antiretroviral treat- ment（ART） -naive HIV -infected patients in Tangshan. Methods Analysis the characters, the first and the last CD4＋ T cell counts and the time interval between the first and the last counting tests of HIV - infected patients reported before December 31, 2015 in Tangshan who had received at least twice CD4＋ T cell counting tests before ART. Describing the natural variation rate of CD4 ＋T cell counts. Logistic regression analysis was used to examine influencing factors of significant depletion of CD4＋ T cell counts. Results 376 HIV - infected patients were included in the study. The monthly variation rate of CD4＋ T cell counts had a median of - 3.5 （ IQR ： - 10. 2 - 2. 2）. The last CD4＋ T cell counts of HIV - infected patients lower than the first time accounted for 66.8% （251/376）, and the HIV - infected patients who had significant depletion of CD4＋ T cell counts accounted for 31.4% （118/376）. Multiple logistic regression analysis results indicated that gender, the first CD4＋ T cell counts and the time interval between the first and the last counting tests were significantly associated with the significant depletion of CD4＋ T cell counts of HIV - infected patients. Conclusion The natural variation rate of CD4 ＋T cell counts of ART - naive HIV - infected patients in Tang- shan was overall smooth. Some of HIV - infected patients showed significant decreases of CD4 ＋T cell counts was related to many factors. Strengthen the management of follow - up in HIV - infected patients. Monitor closely the changing of CD4＋ T cell counts and its changing rates to initiate ART, if necessary.