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

覃川; 蒙新梅; 张鹏; 胡家光; 李敏基; 黄小红; 韦红卫

doi:10.16462/j.cnki.zhjbkz.2023.12.006

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

doi: 10.16462/j.cnki.zhjbkz.2023.12.006

覃川^{1, 2, 3},
蒙新梅^{1, 2, 3},
张鹏^{1, 2, 3},
胡家光^{1, 2, 3},
李敏基^{1, 2, 3},
黄小红^{1, 2, 3},
韦红卫^4, ,

1.
柳州市人民医院感染性疾病科，柳州 545006
2.
广西临床疾病生物技术研究重点实验室，柳州 545006
3.
柳州市传染病免疫研究重点实验室，柳州 545006
4.
柳州市人民医院全科医学科，柳州 545006

基金项目:

广西壮族自治区卫生和计划生育委员会自筹经费科研课题 Z20180286

详细信息

通讯作者:
韦红卫，E-mail: 13607722185@163.com

中图分类号: R512.91
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-15
- 修回日期: 2022-03-27
- 刊出日期: 2023-12-10

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

QIN Chuan^{1, 2, 3},
MENG Xinmei^{1, 2, 3},
ZHANG Peng^{1, 2, 3},
HU Jiaguang^{1, 2, 3},
LI Minji^{1, 2, 3},
HUANG Xiaohong^{1, 2, 3},
WEI Hongwei^{4
, ,}

1.
Department of Infectious Diseases Section, Liuzhou People′s Hospital, Liuzhou 545006, China
2.
Guangxi Key Laboratory for Biotechnology of Clinical Disease, Liuzhou 545006, China
3.
Liuzhou Key Laboratory for Immunization Research of Infectious Disease, Liuzhou 545006, China
4.
General Medicine Department, Liuzhou People′s Hospital, Liuzhou 545006, China

Funds:

Guangxi Zhuang Autonomous Region Health and Family Planning Commission Self-Funded Scientific Research Project Z20180286

More Information

Corresponding author: WEI Hongwei, E-mail: 13607722185@163.com

摘要

摘要: 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(1 248±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。
- 男男性行为者 /
- HIV /
- AIDS /
- 高效抗逆转录病毒治疗
Abstract: 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 (1 248±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.
- Men who have sex with men /
- HIV /
- AIDS /
- Highly active anti-retroviral therapy

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表 1 2组人口学资料、WHO病情分期、初始HAART方案

Table 1. Demographic data, WHO staging, initial HAART regimen of two groups

变量Variable	快速进展组 ^①Rapid progression group ^①(n=68)	非快速进展组 ^①Non-rapid progression group ^①(n=40)	t/χ²值value	P值value
年龄/岁, (x±s) Age/year, (x±s)	31.00±10.00	28.00±9.00	0.938	0.350
婚姻状况Marriage status			0.142	0.706
未婚Unmarried	40(58.82)	25(62.50)
已婚Married	28(41.18)	15(37.50)
职业Occupation			0.422	0.516
学生Student	35(51.47)	18(45.00)
非学生Non-student	33(48.53)	22(55.00)
文化程度Education level			1.289	0.256
本科或研究生Undergraduate or graduate student	42(61.76)	29(72.50)
除本科或研究生以外文化程度 ^② Except for undergraduate or graduate student ^②	26(38.24)	11(27.50)
WHO分期WHO staging			2.231	0.315
1期、2期Phase 1, Phase 2	61(89.71)	39(97.50)
3期、4期Phase 3, Phase 4	7(10.29)	1(2.50)
初始HAART方案 ^③ Initial HAART scheme ^③			0.156	0.693
含LPV/r Containing LPV/r	18(26.47)	12(30.00)
不含LPV/r Non-containing LPV/r	50(73.53)	28(70.00)
注：HAART, 高效抗逆转录病毒治疗; CD4，CD4⁺T淋巴细胞; CD8，CD8⁺T淋巴细胞; VL，病毒载量。 ①以[人数(占比/%)]表示; ②包括专科、中专、职业高中、普通高中、初中; ③根据是否包含蛋白酶抑制剂洛匹那韦/利托那韦(Lopinavir/Ritonavir, LPV/r)，分为含LPV/r、不含LPV/r 2类; 快速进展组、非快速进展组的初始HAART方案均不包含其他蛋白酶抑制剂，不包含整合酶抑制剂及国家免费HAART药物目录之外的自费HAART药物。 Note: HAART, highly active anti-retroviral therapy; CD4, CD4⁺T cell; CD8, CD8⁺T cell; VL, viral load. ① [Number of people (proportion/%)]; ② Including junior college, technical secondary school, vocational high school, ordinary high school and junior high school; ③ According to the inclusion of protease inhibitor Lopinavir/Ritonavir(LPV/r), initial HAART scheme were divided into two categories: containing LPV/r and non-containing LPV/r, and the initial HAART regimens of rapid progress group and non-rapid progress group did not contain other protease inhibitors, integrase inhibitors and self-financed HAART drugs outside the national free HAART drug catalogue.

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表 2 2组基线检验结果以及HAART启动后免疫重建情况

Table 2. Results of baseline tests and immune reconstitution after HAART initiation of two groups

变量Variable	HAART 启动时间/月 HAART start time/month	快速进展组 Rapid progression group (x±s)	非快速进展组 Non-rapid progression group (x±s)	2组间对比 Comparison between the two groups		协方差分析 Covariance analysis
变量Variable	HAART 启动时间/月 HAART start time/month	快速进展组 Rapid progression group (x±s)	非快速进展组 Non-rapid progression group (x±s)	t值 value	P值 value	F值 value	P值 value
CD4计数/(个·μL^-1) CD4 count /(copies·μL^-1)	0	3.84±1.14	469.00±101.00	13.224	＜0.001	― ^②	― ^②
	12	435.00±175.00 ^①	623.00±228.00 ^①	― ^②	― ^②	0.039	0.845
	24	468.00±182.00 ^①	684.00±279.00 ^①	― ^②	― ^②	0.130	0.719
CD8计数/(个·μL^-1) CD8 count /(copies·μL^-1)	0	933.00±430.00	1 248.00±476.00	3.515	0.001	― ^②	― ^②
	12	894.00±444.00 ^①	928.00±364.00 ^①	― ^②	― ^②	0.295	0.588
	24	850.00±378.00 ^①	903.00±417.00 ^①	― ^②	― ^②	0.110	0.741
CD4/CD8	0	0.29±0.19	0.43±0.19	3.583	0.001	― ^②	― ^②
	12	0.59±0.32 ^①	0.74±0.31 ^①	― ^②	― ^②	0.101	0.751
	24	0.62±0.29 ^①	0.84±0.33 ^①	― ^②	― ^②	4.244	0.042
外周血白细胞计数/(10⁹·L^-1) Peripheral blood leukocyte count/(10⁹·L^-1)	0	5.65±2.12	6.93±2.18	3.003	0.003	― ^②	― ^②
	12	5.48±1.97	6.15±1.54	― ^②	― ^②	0.417	0.520
	24	5.93±2.13	6.52±1.82	― ^②	― ^②	0.014	0.908
外周血淋巴细胞计数/(10⁹·L^-1) Peripheral blood lymphocyte count/(10⁹·L^-1)	0	1.76±0.67	2.38±0.78	5.028	＜0.001	― ^②	― ^②
	12	1.97±0.58	2.43±0.66	― ^②	― ^②	0.819	0.368
	24	2.03±0.63	2.48±0.61	― ^②	― ^②	3.113	0.081
HIV VL/(lgcopy·mL^-1)	基线Base line	3.84±1.14	3.85±1.15	0.006	0.996	― ^②	― ^②
注：HAART, 高效抗逆转录病毒治疗; CD4，CD4⁺T淋巴细胞; CD8，CD8⁺T淋巴细胞; VL，病毒载量。 ①与基线值相比，P＜0.05。② “―”代表“不适用”。 Note: HAART, highly active anti-retroviral therapy; CD4, CD4⁺T cell; CD8, CD8⁺T cell; VL, viral load. ① Compared with the baseline value, P＜0.05. ② "―" stands for "not applicable".

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变量Variable	快速进展组 ^①Rapid progression group ^①(n=68)	非快速进展组 ^①Non-rapid progression group ^①(n=40)	t/χ²值value	P值value
年龄/岁, (x±s) Age/year, (x±s)	31.00±10.00	28.00±9.00	0.938	0.350
婚姻状况Marriage status			0.142	0.706
未婚Unmarried	40(58.82)	25(62.50)
已婚Married	28(41.18)	15(37.50)
职业Occupation			0.422	0.516
学生Student	35(51.47)	18(45.00)
非学生Non-student	33(48.53)	22(55.00)
文化程度Education level			1.289	0.256
本科或研究生Undergraduate or graduate student	42(61.76)	29(72.50)
除本科或研究生以外文化程度 ^② Except for undergraduate or graduate student ^②	26(38.24)	11(27.50)
WHO分期WHO staging			2.231	0.315
1期、2期Phase 1, Phase 2	61(89.71)	39(97.50)
3期、4期Phase 3, Phase 4	7(10.29)	1(2.50)
初始HAART方案 ^③ Initial HAART scheme ^③			0.156	0.693
含LPV/r Containing LPV/r	18(26.47)	12(30.00)
不含LPV/r Non-containing LPV/r	50(73.53)	28(70.00)
注：HAART, 高效抗逆转录病毒治疗; CD4，CD4⁺T淋巴细胞; CD8，CD8⁺T淋巴细胞; VL，病毒载量。 ①以[人数(占比/%)]表示; ②包括专科、中专、职业高中、普通高中、初中; ③根据是否包含蛋白酶抑制剂洛匹那韦/利托那韦(Lopinavir/Ritonavir, LPV/r)，分为含LPV/r、不含LPV/r 2类; 快速进展组、非快速进展组的初始HAART方案均不包含其他蛋白酶抑制剂，不包含整合酶抑制剂及国家免费HAART药物目录之外的自费HAART药物。 Note: HAART, highly active anti-retroviral therapy; CD4, CD4⁺T cell; CD8, CD8⁺T cell; VL, viral load. ① [Number of people (proportion/%)]; ② Including junior college, technical secondary school, vocational high school, ordinary high school and junior high school; ③ According to the inclusion of protease inhibitor Lopinavir/Ritonavir(LPV/r), initial HAART scheme were divided into two categories: containing LPV/r and non-containing LPV/r, and the initial HAART regimens of rapid progress group and non-rapid progress group did not contain other protease inhibitors, integrase inhibitors and self-financed HAART drugs outside the national free HAART drug catalogue.

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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

doi: 10.16462/j.cnki.zhjbkz.2023.12.006

通讯作者: 韦红卫，E-mail: 13607722185@163.com

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出版历程

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

Corresponding author: WEI Hongwei, E-mail: 13607722185@163.com

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通讯作者:
韦红卫，E-mail: 13607722185@163.com