早发现早治疗有利于HIV感染者CD4/CD8比值的恢复

Effects on recovery of CD4/CD8 ratio of HIV infected individuals by initiation of ART during acute HIV infection

目的探究1型艾滋病病毒(HIV-1)感染者CD4^+T淋巴细胞(简称CD4细胞)数/CD8^+T淋巴细胞(简称CD8细胞)数(CD4/CD8比值)恢复的影响因素,为HIV感染者的免疫功能恢复提供理论依据。方法以云南省德宏州治疗库数据为材料,从中筛选符合要求的HIV感染者数据,通过单因素和多因素Logistic回归分析探究影响HIV感染者CD4/CD8比值恢复的因素。结果共筛选出符合条件的HIV感染者2 610例,年龄中位数为42岁[四分位距(IQR),35~50];其中男性为1 390人(53.3%);新发感染状态已知的为2 039例;确诊至治疗间隔中位数为21周(IQR,2~183);CD4细胞基线、CD8细胞基线和CD4/CD8比值基线中位数分别为245个/μL(IQR,131~366)、895个/μL(IQR,595~1 260)和0.25(IQR,0.15~0.41)。Logistic回归分析结果显示,新发感染状态、基线CD4细胞、CD8细胞、确诊至抗病毒治疗间隔和性别是影响HIV感染者CD4/CD8比值恢复的重要因素(P<0.05)。结论 CD4/CD8比值的恢复较CD4细胞数的增加需要更长的时间,早诊断早治疗有利于HIV感染者CD4/CD8比值的恢复。

Objective To determine the factors associated to the recovery of CD4/CD8 ratio among HIV infected individuals.Methods Samples were screened from the treatment database of Dehong CDC,Yunnan province.Logistic regression was used to identify risk factors for the recovery of CD4/CD8 ratio.Results We screened out 2 610 samples with median age of 42(IQR,35-50),CD4 and CD8 Tcell counts of 245(IQR,131-366)cells/μL and 895(IQR,595-1260)cells/μL,CD4/CD8 ratio of 0.25(IQR,0.15-0.41),interval between HIV confirmation and ART of 21(IQR,2-182)weeks.Among the infected individuals,1 390(53.3%)were male and 297 were recent infection.Univariate and multivariate logistic regression analysis indicated that gender,recent infection,CD4 and CD8 counts,interval between HIV confirmation and ART were factors associated to the recovery of CD4/CD8 ratio among HIV infected individuals.Conclusion The recovery of CD4/CD8 ratio takes more time than the increase of CD4 cell count.Initiation of ART during acute HIV infection has positive effects on the recovery of CD4/CD8 in HIV infected individuals.