基线年龄对艾滋病抗病毒治疗长期免疫功能的影响

Effect of baseline age on long-term immune function of HIV antiviral therapy

目的探讨基线年龄艾滋病毒感染或艾滋病(HIV/AIDS)患者抗逆转录病毒治疗(ART)对长期免疫功能的影响。方法收集2004年1月至2021年12月期间在柳州市人民医院关爱门诊随访的初治患者作为研究对象,共计1832例。其中男1292例,女540例。按基线年龄分为3组,分别为<35岁年龄组557例、35~50岁年龄组675例、>50岁年龄组600例。每3个月随访1次,应用广义估计方程(GEE)比较3个年龄组患者在启动ART后(0~120个月)外周血CD4+T淋巴细胞计数增长情况是否有统计学差异。结果GEE参数估计值结果显示,在启动ART后的随访66个月内,不同年龄组间的CD4+T淋巴细胞计数变化情况差异有统计学意义(P<0.05),在随访66个月之后,不同年龄组间的CD4+T淋巴细胞计数变化情况差异无统计学意义(P>0.05)。结论艾滋病患者经抗病毒治疗后,随着治疗时间延长,大部分患者免疫功能均可获得一定程度恢复,但>50岁的患者需重点关注。

Objective To investigate the effects of antiretroviral therapy(ART)on long-term immune function in baseline age patients with HIV infection or AIDS.Methods A total of 1832 newly treated patients who were followed up in the care outpatient department of Liuzhou People′s Hospital from January 2004 to December 2021 were collected,including 1292 males and 540 females.Patients were categorized into three groups based on baseline age:Group 1(age<35 years,557 patients),Group 2(age 35-50 years,675 patients),and Group 3(age>50 years,600 patients).Follow-up visits were conducted every three months.The generalized estimating equation(GEE)was used to compare the changes in peripheral blood CD4+T lymphocyte counts after initiating ART(0-120 months)among the three age groups.Results The GEE parameter estimates indicated that there were statistically significant differences in CD4+T lymphocyte count changes among the age groups during the first 66 months of follow-up after initiating ART(P<0.05).However,after 66 months of follow-up,there were no statistically significant differences in CD4+T lymphocyte count changes among the age groups(P>0.05).Conclusion Most HIV/AIDS patients experience a certain degree of immune function recovery with extended treatment duration.However,special attention should be given to patients over 50 years of age.