病情快速进展对MSM HIV/AIDS患者高效抗逆转录病毒治疗后免疫重建效果的影响

Effect of rapid progression on immune reconstitution after highly active anti-retroviral therapy in HIV/AIDS men who have sex with men

目的探讨病情快速进展对男男性行为者(men who have sex with men,MSM)HIV/AIDS患者高效抗逆转录病毒治疗(highly active anti-retroviral therapy,HAART)后免疫重建效果的影响。方法将108例MSM HIV/AIDS患者分为快速进展组(68例)、非快速进展组(40例),对2组HAART启动后24个月免疫重建相关指标的恢复情况进行分析。结果随着HAART的进行,2组的CD4^(+)T淋巴细胞(CD4)计数、CD4/CD8^(+)T淋巴细胞(CD8)(CD4/CD8比例)比例均逐渐回升,在HAART启动后24个月,快速进展组的CD4/CD8比例(0.62±0.29)低于非快速进展组(0.84±0.33)(F=4.244,P=0.042);快速进展组的基线CD8计数(933±430)个/μL低于非快速进展组(1248±476)个/μL(t=3.515,P=0.001),之后2组CD8计数逐渐回落至相似水平(F=0.110,P=0.741),快速进展组的回落幅度小于非快速进展组。结论对于MSM HIV/AIDS患者,病情快速进展将对HAART免疫重建效果造成负性影响。

Objective To explore the effect of rapid disease progression on immune reconstitution after highly active anti-retroviral therapy(HAART)in HIV/AIDS MSM.Methods A total of 108 HIV/AIDS MSM were divided into rapid progression group(n=68)and non-rapid progression group(n=40).The recovery of immune reconstitution related indexes in two groups after HAART 24 months were statistically analyzed.Results During the progress of HAART,CD4^(+)T cell(CD4)count and CD4/CD8^(+)T cell(CD8)ratio in both groups gradually increased,and CD4/CD8 ratio in rapid progression group was lower than that in non-rapid progression group(0.62±0.29 vs.0.84±0.33,F=4.244,P=0.042)after 24 months of HAART initiation.The baseline CD8 count in rapid progression group(933±430)was lower than that in non-rapid progression group(1248±476)(t=3.515,P=0.001),and then CD8 count in both groups gradually decreased to a similar level(F=0.110,P=0.741),with smaller decline in rapid progression group than in non-rapid progression group.Conclusion For HIV/AIDS MSM,the rapid disease progression will have a negative effect on immune reconstitution of HAART.