老年HIV感染者抗病毒治疗后CD4^(+)T淋巴细胞增长的影响因素分析

Analysis of influencing factors of CD4^(+)T-lymphocyte growth in elderly HIV-infected patients after antiviral treatment

目的探讨老年HIV感染者抗病毒治疗后CD4^(+)T淋巴细胞增长的影响因素。方法采用电子问卷形式对全国多地的HIV感染者进行流行病学调查,并对其中抗病毒治疗1年且年龄≥50岁的感染者进行分析。比较不同人口学特征、自评健康状况及健康行为老年HIV感染者治疗前后CD4^(+)T淋巴细胞计数的变化。采用多元线性回归分析评估老年HIV感染者抗病毒治疗后CD4^(+)T淋巴细胞变化的影响因素。结果共纳入老年HIV感染者92例,男女比例为3∶1,平均年龄为(60.12±7.71)岁,治疗前、后CD4^(+)T淋巴细胞计数分别为(207.83±168.07)个/μl、(263.49±183.66)个/μl,差异有统计学意义(P<0.01)。不同婚姻状态、是否吸烟及是否锻炼老年HIV感染者治疗前后CD4^(+)T淋巴细胞变化值比较差异均有统计学意义(P<0.05)。多元线性回归分析结果显示,吸烟是老年HIV感染者抗病毒治疗后CD4^(+)T淋巴细胞计数增长的危险因素,锻炼是老年HIV感染者抗病毒治疗后CD4^(+)T淋巴细胞计数增长的保护因素(P<0.05)。结论鼓励老年HIV感染者戒烟并进行适当的体育锻炼,保持良好的健康行为习惯对老年HIV感染者CD4^(+)T淋巴细胞的增长有积极作用。

Objective To investigate the influencing factors of CD4^(+)T-lymphocytes growth in elderly HIV-infected patients after antiviral treatment(ART).Methods An electronic questionnaire was used to conduct an epidemiological survey of HIV-infected patients in multiple locations across China and to analyze those who had been on antiviral treatment for 1 year and were aged≥50 years old.Changes of CD4^(+)T-lymphocyte counts were compared before and after treatment among older HIV-infected patients with different demographic characteristics,self-rated health status and health behaviours.Multiple linear regression analysis was used to assess the factors influencing changes in CD4^(+)T-lymphocytes after ART in older HIV-infected patients.Results A total of 92 elderly HIV-infected patients were included,with a male to female ratio of 3∶1 and a mean age of(60.12±7.71)years.The CD4^(+)T-lymphocyte count was(207.83±168.07)cells/μl before treatment and(263.49±183.66)cells/μl after treatment,with statistically significant differences between pre-and post-treatment comparisons(P<0.01).Differences of CD4^(+)T-lymphocyte change values before and after treatment were statistically significant(P<0.05)when comparing older HIV-infected patients with different marital status,whether they smoked or not and whether they exercised or not.Multiple linear regression analysis showed that smoking was the risk factor of CD4^(+)T-lymphocytes growth in older HIV-infected patients after antiviral treatment,while exercise was the protective factor of CD4^(+)T-lymphocytes growth in older HIV-infected patients after antiviral treatment(P<0.05).Conclusion Encouraging older HIV-infected patients to quit smoking and engage in appropriate physical activity,and maintaining good health behaviour has a positive effect on CD4^(+)T-lymphocytes growth in elderly HIV-infected patients.