CD4 + T. antiretroviral therapy ART CD4 + T. Kaplan-Meier
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1 HIV /AIDS CD4 + T / human immunodeficiency virus /acquired immunodeficiency syndrome HIV /AIDS antiretroviral therapy ARTCD4 + T CD4 ART HIV /AIDS ART CD4 ART Logistic HIV /AIDS ART immune non-responses INRs Kaplan-Meier ART 777 HIV /AIDS ART CD4 P < Logistic ART CD4 OR = % CI ~ P = OR = % CI ~ P = CD4 > 500 cell /μlor = % CI ~ P < ART 50 OR = % CI ~ P = INRs ART ART 2 = P = = P = CD4 < 200 cell /μl ART ART P < HIV /AIDS ART CD4 ART INRs HIV /AIDSCD4 + T R A DOI /j. cnki. zhjbkz Trends of CD4 + T cell count among HIV /AIDS patients prior to antiretroviral therapy initiation and its association with immunological recovery and mortality after treatment DONG Wen-bin 1 LI Shi-fu 1 ZHAO Jin-xianSU Shu 2 CHEN Li-yue 1 CAI Ying 1 ZHU Yong-fen 1 LIU Xiao-chun 1 LU Jian-bo 1 LI Shun-xiang 1 XU Jie 1 LI Ze 1 WU Qiang Division of HIV /AIDS and STD controlcentre for Disease Control and PreventionYuxi China2. Department of Epidemiology and Preventive MedicineSchool of Public HealthMonash UniversityMelbourne Australia Abstract Objective To examine the association between the natural trends of CD4 + T cell prior to antiretroviral therapy ARTinitation and immunological recovery and mortality after ART among HIV /AIDS patients in Yuxi PrefectureYunnan. Methods The natural changes of the CD4 + T cell before ART were divided into four groups among HIV / AIDS patients the immunologic recovery was described and Kaplan-Meier method were used to describe survival curve a- mong different groups of patients initiated ART. Multivariate logistic regression were used to analyse factors associated with immune non-responses. Results Among 777 HIV /AIDS patients the natural changes of CD4 + T cell after ART was significantly lower in gently and rapidly increased groups than rapidly decline groups among ART-naive HIV / AIDS patients. Multivariate logistic regression analysis indicated that patients with natural increase of CD4 + T cell counts before ART initiation OR = % CI P = OR = % CI P = with baseline CD4 + T cell counts more than 500cell /μl OR = % CI P < and those older than 50 years old at ART initiaiton OR = % CI P = were more likely to have immune non-responses after ART. The cumulative survival rate was significantly lower in gently increased groups than the gently and rapid decline groups 2 = P = = P = further stratified analysis showed that those with baseline CD4 counts less than 200 cell /μlas well all P < Conclusions An association was identified between the natural changes of CD4 + T cell before ART and the immunologic recovery after ARTINRs and mortality. Key words HIV /AIDSCD4 + T lymphocyteartmortalitycorrelation analysis Chin J Dis Control Prev HB @ qq. com ynyxwq1968@ 163. com
2 1230 Chin J Dis Control Prev 2018 Dec2212 human immunodeficiency virus CD4 HIV / HIV / α = AIDS CD4 1 α = antiretroviral therapy ART HIV 2 CD4 2 HIV /AIDS ART 2. 1 CD4 immune non-responsesinrs 3 INRs / HIV ~ 35 4 ART CD4 HIV ART INRs CD ~ 561cells /μl P < ART CD ~ 699cells /μl 374 HIV /AIDS ART CD4 ART 2006 ~ 2016 CD ~ 322cell /μlart ~ 688cell /μl 1 - ART 2. 2 HIV /AIDS ART CD ART CD4 ART CD4 2ART < copies /μl ~ 0. 19cells /μl / ART 5 3 CD4 HIV /AIDS CD4 1 1 ART n = 102 n = CD4 ART 105 n = 279 > 7 d 6 ART > n = 291 CD4 H = HIV /AIDS P < ART 1. 2 CD4 CD ~ 9. 23cells / ART ART CD4 cell /μl/ d d ART ~ 8. 40cells /μl / ART CD4 cells /μl /month ~ 9. 01cells /μl / ART CD IQR1. 85 ~ 9. 53cells /μl / median M CD4 H = P = M ART M ART CD HIV /AIDS ART INRs 587 HIV /AIDS < 50 cop- M ART ies /μl HIV /AIDS ART INRsINRs = 1 M ART 6 INRs ART < Logistic 50 copies /μl CD4 < 30% 200 cells /μl INRsINRs 3 Logistic HIV /AIDS ART HIV CD4 + T INRs CD4 μl / ART CD4 INRs = 0 α < 0. 1 Logistic 1. 3 Excel 2010 ART CD4 SPSS CD4 CD4 OR = % CI ~ P = M interquartile range IQR OR = % CI ~ P = CD4 ART CD CD4 > 500 cell /μl OR = Kaplan-Meier 95% CI ~ P < ART ART CD4 50 OR = % CI ~ P = Log-rank HIV / AIDS ART INRs
3 Table 1 1 CD4 Demographic characteristics and CD4 cell counts in different time periods CD4 ART CD4 ART CD4 n% M IQR H P M IQR H P M IQR H P < ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ / ~ ~ ~ ~ ~ ~ < ~ ~ ~ ~ ~ ~ ~ ~ ~ < < ~ ~ ~ 705 // ~ ~ ~ 721 / ~ ~ ~ ~ ~ ~ ~ ~ ~ 803 ART < < ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 752 > ~ ~ ~ ~ ~ ~ 699 ART 25 ~ 36 > 36 OR = % CI ~ P = OR = % CI ~ P = HIV /AIDS ART INRs ART CD4 2 = P = ART ART 19 ART 2 = P = % CI ~ % CI ~ % CI ~ % CI ~ ART CD4 2 = P = HIV /AIDS ART ART ART 2 = P = CD4 < 200 cell /μl ART = P = CD4 200 cell /μl ART CD4
4 1232 Chin J Dis Control Prev 2018 Dec * 3 2 HIV /AIDS CD4 1 ART CD4 ART change groups of CD4 cell counts among HIV /AIDS patients Figure 1 The CD4 cell change speed by month after ART in different nature change groups of CD4 cell counts before ART 2 HIV /AIDS ART INRs ART CD4 Table 2 Multivariate analysis factors of Zhang 10 causing INRs after ART in HIV /AIDS patients ART CD4 ART β s x珋 Wald OR 95% CI P HIV /AIDS ART CD4 ART CD ~ ART CD ART 18 ~ ~ ~ ~ ~ ~ ~ ART CD ~ ~ ~ CD4 cell /μl < ~ ~ ~ ~ ~ < ART 6 ~ ~ ~ ~ ~ > ~ ART 7 8 ART Figure 2 The survival curve in different nature CD Bajpai 9 HIV /AIDS ~ 0. 19/Patrikar HIV /AIDSART CD4 Philli 15 ART CD4 ART ART Zhu 12 ART ART CD4 ART 16 CD4 INRs HIV /AIDS INRs 3 ART 50 CD4 > 500 cell / μl HIV /AIDS ART INRs 17 ART CD4 ART CD4 > 500 cell /μl HIV /AIDS ART CD4 30% ART CD4 ART INRs ART CD
5 HIV /AIDSART ART CD4 ART CD4 HIV /AIDS ART CD4 HIV /AIDS ART % J CD4 < 200 cell /μl ART ART ART CD4 < 200 cell /μl ART CD4 200 cell /μlart CD4 > 200 cell /μl ART 19 ART HIV /AIDS CD4 < 200 cell /μl ART ART 20 e HIV /AIDS CD4 HIV /AIDS CD4 CD4 CD4 J ART CD4 ART INRs 1Montarroyos URMiranda-Filho DBCésar CCet al. Factors related to changes in CD4 + T- counts over time in patients living with HIV /AIDSa multilevel analysis J. Plos One e Hayes TLAsmuth DMCritchfield J Wet al. Impact of highly active antiretroviral therapy Initiation on CD4 + T-cell repopulation in duodenal and rectal mucosa J. AIDS Yeni PGHammer SMHirsch MSet al. Treatment for adult HIV infection J. JAMA Nakanjako DSsewanyana IMayanja-Kizza Het al. High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort J. BMC Infect Dis J Maskew MBrennan ATWestreich Det al. Gender differences in mortality and CD4 count response among virally suppressed HIV-positive patients J. J Womens Health Larchmt Semeere ASLwanga ISempa Jet al. Mortality and immunological recovery among older adults on antiretroviral therapy at a large urban HIV clinic in KampalaUganda J. J Acquir Immune Defic Syndr Bajpai RCChaturvedi HKBhatnagar Net al. Correlates of change in CD4 count among the HIV patients at antiretroviral treatment centres in Indiacross-sectional analysis of secondary data. Natl J Community Med Zhang FDou ZMa Yet al. Effect of earlier initiation of antiretroviral treatment and increased treatment coverage on HIV-related mortality in Chinaa national observational cohort study J. Lancet Infect Dis INSIGHT START Study GroupLundgren JDBabiker AG. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection J. N Engl J Med Zhu HNapravnik SEron Jet al. Attrition among human immunodeficiency virus HIV-infected patients initiating antiretroviral therapy in China J. Plos One Patrikar SBasannar D RBhatti VKet al. Rate of decline in CD4 count in HIV patients not on antiretroviral therapy J. Med J Armed Forces India CD4^ + T Phillips ANLampe FCSmith CJet al. Ongoing changes in HIV RNA levels during untreated HIV infectionimplications for CD4 count depletion J. AIDS Awoke TWorku AKebede Yet al. Modeling outcomes of firstline antiretroviral therapy and rate of CD4 counts change among a cohort of HIV /AIDS patients in ethiopiaa retrospective cohort study J. Plos One e Hentzien MDramé MAllavena Cet al. Impact of age-related comorbidities on five-year overall mortality among elderly HIV-infected patients in the late HAART era - Role of chronic renal disease J. J Nutr Health Aging Meijerink HWisaksana RIskandar Set al. Injecting drug use is associated with a more rapid CD4 cell decline among treatment nave HIV-positive patients in Indonesia J. J Int AIDS Soc / J HIV /AIDS CD4 + T 5. J. CD4 + T J Saeed NKFarid EJamsheer AE. Prevalence of opportunistic in- 6. fections in HIV-positive patients in Bahraina four-year review HIV CD4 + T J. J Infect Dev Ctries
Chin J Dis Control Prev 2018 Dec antiretroviral therapy ART. DOI /j. cnki. zhjbkz
1238 Chin J Dis Control Prev 2018 Dec2212 1 2 3 3 2 4 5 6 1 2 antiretroviral therapy ART 412 20. 6% 14. 3% ART ART / / R512. 91R373. 51 A 1674-3679201812-1238-05 DOI10. 16462 /j. cnki. zhjbkz. 2018. 12.
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