MSM人群HIV/AIDS基线CD4水平与艾滋病抗病毒治疗效果的关系研究

A study on the association of baseline CD4^+T and early antiretroviral therapy effect among MSM HIV/AIDS patients

目的分析男男性行为(MSM)人群艾滋病病毒感染者和艾滋病患者(HIV/AIDS)基线CD4+T淋巴细胞(CD4)水平对艾滋病抗病毒治疗效果的影响。方法于2014年7月1日—2016年6月30日招募杭州市MSM人群初次接受艾滋病抗病毒治疗的HIV/AIDS,将基线CD4≥500/μL定为观察组,<500/μL定为对照组,定期随访并检测CD4和病毒载量,比较两组HIV/AIDS抗病毒治疗效果。结果共纳入HIV/AIDS 1 206例,其中对照组1 026例,观察组180例。观察组和对照组在治疗随访第12个月时,CD4恢复到719/μL(浙江省正常成人CD4中位数)的比例分别为39.13%和12.50%;第18个月时分别为38.71%和13.75%。观察组CD4首次恢复成功所需的中位时间为7.2个月,少于对照组的20.4个月(P<0.05)。治疗满12个月时,对375例HIV/AIDS进行病毒载量检测,病毒抑制成功(<400 copies/m L)365例,占97.33%。观察组和对照组的病毒抑制成功率分别为96.34%和97.50%,差异无统计学意义(P>0.05)。结论基线CD4≥500/μL和<500/μL的MSM人群HIV/AIDS抗病毒治疗病毒抑制成功率相近,前者CD4首次恢复用时较短。

Objective To analyze the association between baseline level of CD4＋T and the therapeutic effects of highlyactive antiretroviral therapy （HAART ） for MSM HIV/AIDS in Hangzhou City. Methods We recruited MSM HIV/AIDSwho initiated HAART from July 1st 2014 to June 30th 2016 into the study in Hangzhou City. MSM HAART patients whosebaseline CD4＋T≥500 copies/μL was set as observation group,and baseline CD4＋T〈500 copies/μL was set as controlgroup. Patients were tested CD4 count and viral load regularly. We compared HAART effects of observation group andcontrol group. Results We recruited 1 206 MSM patients with access to HAART in our study in Hangzhou City. And1026 patients were set in control group,and 180 patients were set in observation group. In the 12th month,the rates of twogroups＇ patients with CD4 successfully recovered （reached 719 cells/μL ） were 12.50% and 39.13%. In the 18th month,the rates were 13.75% and 38.71%. The median time of patients with CD4 first successfully recovered to 719 cells/μL was7.2 month s in observation group,while the median time of control group was 20.4 months,which was longer thanobservation group （P〈0.05） .A total of 375 patients were tested viral load,and the successful suppression rate of viralload was 97.33%. The rates of observation and control group were 96.34% and 97.50% （P〉0.05） . Conclusion Therates of viral successful suppression were similar between baseline CD4 counts ≥500 cells/滋L group and〈500 cells/滋Lgroup among MSM HAART patients. Recovery time in baseline CD4 counts ≥500 cells/滋L group was shorter than baselineCD4 counts〈500 cells/滋L group.