Effect of baseline CD4+T lymphocyte counts on immune function reconsti-tution after antiviral therapy in human immunodeficiency virus/acquired immunodeficiency syndrome patients
Effect of baseline CD4+T lymphocyte counts on immune function reconsti-tution after antiviral therapy in human immunodeficiency virus/acquired immunodeficiency syndrome patients
Objective To investigate the effect of baseline CD4+T lymphocyte counts on immune function reconstitution after antiviral therapy in human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)patients,and to provide evidence for judging the efficacy of antiviral therapy.Methods The clinical data of 755 HIV/AIDS patients with more than 24 weeks of antiviral treatment in Ganzhou City from 2019 to 2022 were selected,and CD4+T lymphocyte counts and viral load were detected in peripheral blood.According to the CD4+T lymphocyte counts after 24 weeks of antiviral treatment,the patients were divided into good immunoreconstructive group(≥ 200/μ l)and poor immunoreconstructive group(＜200/μl).In multivariate analysis,binary logistic regression was used and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the model.Results Among 755 patients,614(81.3％)had good immune reconstitution and 141(18.7％)had poor immune reconstitution.Virological indicators showed successful virological inhibition in 617 cases(81.7％)and failure in 138 cases(18.3％).The proportion of baseline CD4T lymphocyte count＞500/μl in poor immune reconstitution group was lower than that in good immune reconstitution group,and the difference was statistically significant(P＜0.05).Univariate analysis showed that immune reconstitution was associated with gender,age,treatment time and baseline CD4+T lymphocyte counts,and the differences were statistically significant(P＜0.05).Multivariate analysis by logistic regression model showed that the gender of female(β=-0.642,O R=0.526.95％CI:0.288-0.962),treatment time 1-2 years(β=-0.538,OR=0.584,95％CI:0.383-0.890),baseline C D4T lymphocyte count 200-500/μl(β=-2.761,OR=0.063,95％CI:0.035-0.116)and baseline CD4+T lymphocyte count＞500/μl(β=-3.206,OR=0.041,95％CI:0.010-0.169)were independent protective factors for poor immune reconstitution(P＜0.05).Age＞50 years old(β=1.554,OR=4.730,95％CI:1.028-21.751)was an independent risk factor for poor immune reconstruction(P＜0.05).Baseline CD4+T lymphocyte count models predicted poor immune reconstitution with an area under the ROC curve of 0.834(P＜0.05).Conclusion Gender,age,duration of antiviral therapy and baseline CD4T lymphocyte count are independent factors for immune reconstitution in HIV/AIDS patients.
关键词
人类免疫缺陷病毒/艾滋病患者/CD4+T淋巴细胞计数/基线/免疫重建/病毒载量
Key words
Human immunodeficiency virus/acquired immunodeficiency syndrome patient/CD4 T lymphocyte count/Baseline/Immune reconstitution/Viral load
万方数据