Effect of baseline CD4+T lymphocyte counts and HIV viral load on the efficacy of integrase inhibitor-based regimens:a meta-analysis
Objective To examine the effect of baseline CD4+T lymphocyte(CD4 cell)counts and HIV viral load on the efficacy of integrase inhibitor-based regimens among HIV-infected individuals.Methods Publications pertaining to the effect of baseline CD4 cell counts and HIV viral load on the efficacy of integrase inhibitor-based regimens among HIV-infected individuals were retrieved in national and international electronic databases,including CNKI,Wanfang Data,VIP,PubMed and Web of Science.The quality of publications that met the inclusion criteria was evaluated and all original data were extracted from included publications.Subgroup ana-lyses were performed to compare the failure in treatment with integrase inhibitor-based regimens between HIV-infected individuals with baseline CD4 cell counts of＜200 cells/μL and those with baseline CD4 cell counts of 200 cells/μ.L and greater,and between HIV-infected individuals with HIV viral load of＞105 copies/mL and those with viral load of 105 copies/mL and lower.All meta-analyses were performed with R package.Results A total of 29 eligible publications were included.Meta-analysis showed a higher risk of treatment failure among HIV-infected individuals with baseline CD4 cell counts of＜200 cells/μL and receiving integrase inhibitor-based regimens for 48[odds ratio(OR)=1.93,95％confidential interval(CI):(1.47,2.54),P=0.01]and 96 weeks[OR=1.53,95％CI:(1.13,2.09),P＜0.01]than among those with baseline CD4 cell counts of 200 cells/μL and greater,and a higher risk of treatment fail-ure among HIV-infected individuals with baseline HIV viral load of＞105 copies/mL and receiving integrase inhibitor-based regimens for 48 weeks than among those with baseline HIV viral load of 105 copies/mL and lower[OR=1.82,95％CI:(1.37,2.42),P＜0.01].Conclusions Baseline CD4 cell counts and HIV viral load are important factors affecting the response to integrase inhibitor-based reg-imens.The"immediate antiretroviral therapy"policy is strongly recommended to facilitate early identification,early diagnosis and early treatment of HIV-infected individuals.
NETL
NSTL
万方数据
