郑州市不同年龄HIV/AIDS患者抗病毒治疗效果及影响因素分析

Effects and influencing factors of antiretroviral therapy among HIV/AIDS patients of different ages in Zhengzhou

目的了解郑州市不同年龄HIV/AIDS患者的ART效果,探讨影响免疫恢复的影响因素。方法收集郑州市2010年1月1日至2018年12月31日期间初始ART的HIV/AIDS患者相关信息,根据ART时年龄不同将HIV/AIDS患者分为老年组(≥50岁)、青年组(18~40岁)。应用混合线性模型对数据进行分析,以各随访时间点的CD4细胞计数为因变量,综合分析性别、感染途径、基线CD4细胞等因素对CD4细胞计数水平的影响。结果共纳入1853例研究对象,其中老年组426例,青年组1427例。老年组和青年组中分别有78.9%(336/426)、82.8%(1182/1427)的患者病毒持续抑制,差异无统计学意义(χ^(2)=3.470,P=0.062)。ART后CD4细胞计数逐渐上升,两组患者在ART 48个月中,相比于基线CD4细胞计数≤200个/μL的患者,基线CD4细胞计数为201~350个/μL和>350个/μL的患者治疗后CD4细胞计数更高,青年组ART后的CD4细胞计数[(472±12)个/μL]高于老年组[(430±14)个/μL],固定效应参数估计值为42.283(F=28.315,P<0.001)。结论HIV/AIDS患者ART后可获得较好的病毒学效果,老年患者治疗后CD4细胞计数水平低于青年患者,年龄是患者ART后免疫功能恢复的影响因素,在艾滋病防治中应给予老年人群更多关注。

Objective To understand the effect of antiretroviral therapy(ART)among HIV/AIDS patients of different age groups living in Zhengzhou City.Moreover,this study aimed to explore the factors that affect immune recovery.Methods Data on patients with HIV/AIDS,who were given ART from January 1,2010 to December 31,2019 in Zhengzhou City,were collected.The patients were divided into two groups,depending on the age of ART initiation.The older adult group consisted of those who were at least 50 years old,while the youth group consisted of those 18-40 years old.A mixed linear model was used to analyze the data.The CD4 cell count at each follow-up consultation was set as the dependent variable.The effect of other factors,such as sex,route of infection,and baseline CD4 cell count,was analyzed.Results A total of 1853 subjects were enrolled in this study.Of these,426 belonged to the older adult group and 1427 belonged to the youth group.There were 78.9%(336/426)and 82.8%(1182/1427)patients with persistent virus inhibition in the older adult and youth groups,respectively,but this difference was not significant(χ^(2)=3.470,P=0.062).For both groups,within 48 months after initiation of ART,patients with a baseline CD4 count of"201-350/μL"and">350/μL"had a higher CD4 count than those with a baseline CD4 count of less than 200/μL.In the youth group,the CD4 count after initiation of ART[(472±12)/μL]was higher than that of the older adult group[(430±14)/μL],with a fixed effect parameter estimate of 42.283(F=28.315,P<0.001).Conclusions Patients with HIV/AIDS can achieve good virological outcomes with ART.Even with ART,the CD4 cell count of older patients after treatment is lower than that of young patients.Age is an influencing factor in the immune function recovery of patients,and further attention should be paid to prevent and manage AIDS in the older patients.