Trends of CD4/CD8 ratio changes and influencing factors among HIV/AIDS patients on long term antiretroviral therapy
Objective To examine the longitudinal changes in the CD4/CD8 cell ratio among HIV/AIDS patients undergoing combination antiretroviral therapy(cART)and analyze the factors influencing these changes.Methods This study included HIV/AIDS patients who underwent cART at an infectious disease clinic in Hangzhou between July 2005 and January 2023.Baseline data and follow-up laboratory results were collected using questionnaires and the Infectious Disease Reporting Information Management System that is a subsystem of the Information System of Chinese Center for Disease Control and Prevention.The correlation between the CD4/CD8 cell ratio and cART duration was assessed using Spearman's rank correlation.Generalized linear mixed models(GLMM)were used to analyze temporal trends in the CD4/CD8 ratio and its influencing factors.Results Of the 2 187 HIV/AIDS patients included,2 071 were male(94.7％),with a mean age at treatment initiation of 33.0±11.0 years.Spearman's rank correlation analysis indicated that with longer treatment duration,the CD4 count(r=0.340,P＜0.001)and CD4/CD8 ratio(r=0.415,P＜0.001)exhibited increasing trends,whereas the CD8 count(r=-0.182,P＜0.001)decreased.GLMM analysis revealed that after controlling for time effects,being female(β=0.095,95％CI:0.061-0.129),older age at treatment initiation(β≥60.0 years=0.153,95％CI:0.112-0.193;β30.0-＜60 years=0.025,95％CI:0.009-0.041),smoking(β=0.062,95％CI:0.045-0.079),shorter delay in treatment initiation(≤6 months,β=0.120,95％CI:0.100-0.141),baseline CD4 count(β200-349 cellμL=0.264,95％CI:0.239-0.289;β350-499cells/μL=0.414,95％CI:0.387-0.440;β≥500 cells/μL=0.535,95％CI:0.505-0.564),and baseline viral load(1×105-4.99 999×105 copies/mL,β=0.035,95％CI:0.015-0.055)were protective factors for CD4/CD8 ratio recovery.Conversely,higher education level(βhigh school=-0.048,95％CI:-0.076--0.019;βcollege=-0.078,95％CI:-0.105--0.051;βundergraduate=-0.104,95％CI:-0.131--0.078;βpostgraduate and above=-0.098,95％CI:-0.136--0.061),alcohol consumption(β=-0.034,95％CI:-0.050--0.018),and prior use of cotrimoxazole(β=-0.046,95％CI:-0.075--0.018)were identified as risk factors for impaired CD4/CD8 recovery.Conclusions Over time,the CD4/CD8 ratio exhibited an upward trend with significant associations with factors such as sex,age at treatment initiation,smoking,alcohol consumption,educational level,treatment delay,baseline CD4 count,baseline viral load,and co-trimoxazole use.
万方数据
维普
