不同体成分及其他因素与高效抗逆转录病毒治疗后免疫重建不全的相关性

发布时间：2018-04-18 03:07

本文选题：人类免疫缺陷病毒 + 高效抗逆转录病毒治疗　；参考：《中国医学科学院学报》2017年04期

【摘要】：目的分析不同体成分及其他因素与中国男性人类免疫缺陷病毒(HIV)或获得性免疫缺陷综合征(AIDS)患者接受高效抗逆转录病毒治疗(HAART)后免疫重建不全的相关性。方法回顾性分析2007年至2015年接受HAART1年以上并获得病毒抑制(HIV-1 RNA400拷贝/ml)的男性HIV/AIDS患者资料,包括患者临床、免疫学及病毒学资料,其中包括HAART开始前1个月内测量的患者体质量、身高、全身体成分。经身高校正后得到体质量指数(BMI)、肌肉指数(LMI)、脂肪指数(FMI)、骨矿含量/身高。根据患者接受HAART 1年后是否出现免疫重建不全(CD4细胞计数350细胞/μl),将患者分为免疫学未完全应答组(CD4细胞计数350细胞/μl)、免疫学完全应答组(CD4细胞计数≥350细胞/μl)。应用t检验、卡方检验及Wilcoxon秩和检验比较两组患者的差异,应用多因素Logistics回归分析接受HAART 1年后免疫重建不全的影响因素。结果共纳入84例男性HIV/AIDS患者。两组患者的年龄(Z=-2.479,P=0.013)、基线BMI(t=2.030,P=0.045)、LMI(t=2.200,P=0.029)、CD4细胞计数(Z=6.416,P=0.000)差异有统计学意义。两组患者的基线病毒载量、FMI、骨矿含量/身高、HAART时间、HAART方案差异无统计学意义(P0.05)。BMI(OR=0.742,95%CI=0.554-0.993,P=0.044)、LMI(OR=0.459,95%CI=0.249-0.844,P=0.012)、HAART时间(OR=10.161,95%CI=1.110-93.052,P=0.040)、基线CD4细胞计数(OR=80.051,95%CI=8.396-762.563,P=0.000)与免疫重建不全具有相关性。年龄(OR=1.497,95%CI=0.213-10.505,P=0.685)、病毒载量(OR=0.333,95%CI=0.071-1.572,P=0.164)、FMI(OR=0.797,95%CI=0.546-1.164,P=0.240)、全身骨矿含量/身高(OR=1.145,95%CI=0.037-35.676,P=0.938)及HAART方案(OR=0.430,95%CI=0.159-1.159,P=0.095)与免疫重建不全无相关性。结论基线CD4细胞计数及治疗时间可影响免疫重建,基线BMI或基线LMI较高是免疫重建不全的保护因素,基线FMI和全身骨矿物质含量/身高与免疫重建不全无关。
[Abstract]:Composition and other factors and Chinese male human immunodeficiency virus of different objective analysis (HIV) or acquired immunodeficiency syndrome (AIDS) patients receiving highly active antiretroviral therapy (HAART) correlation immune reconstitution. Methods a retrospective analysis from 2007 to 2015 for HAART1 years and viral suppression (HIV-1 RNA400 copy /ml) male HIV/AIDS patients, including clinical, immunological and virological data, including HAART of body weight, measured within 1 months before the height, whole body composition. The body is higher after body mass index (BMI), get the muscle index (LMI), fat index (FMI), bone height mineral content /. According to the patients received HAART after 1 years is the emergence of immune reconstitution (CD4 cell count of 350 cells / L), the patients were divided into non immunological complete response group (CD4 cell count of 350 cells / L), immunology Complete response group (CD4 cell count above 350 cells / L). The application of difference t test, chi square test and Wilcoxon rank test were compared between the two groups, using multivariate Logistics regression analysis for factors affecting HAART immune reconstitution after 1 years. The results of 84 cases of male HIV/ patients with AIDS were included. Two groups of patients with age (Z=-2.479, P=0.013), BMI (t=2.030, P=0.045) at baseline, LMI (t=2.200, P=0.029), CD4 cell count (Z=6.416, P=0.000) the difference was statistically significant. The two groups of patients with baseline viral load, FMI, bone mineral content / height, HAART time, there was no significant difference for HAART (P0.05).BMI (OR=0.742,95%CI=0.554-0.993, P=0.044), LMI (OR=0.459,95%CI=0.249-0.844, P=0.012), HAART (OR=10.161,95%CI=1.110-93.052, P=0.040), the baseline CD4 cell count (OR=80.051,95%CI= 8.396-762.563, P=0.000) and immune reconstitution associated with age (O. R=1.497,95%CI=0.213-10.505, P=0.685), viral load (OR=0.333,95%CI=0.071-1.572, P=0.164), FMI (OR=0.797,95%CI=0.546-1.164, P=0.240), bone mineral content / body height (OR=1.145,95%CI=0.037-35.676, P=0.938) and HAART (OR=0.430,95%CI= 0.159-1.159 P=0.095) no correlation with immune reconstitution. Conclusion the baseline CD4 cell count and the treatment time can affect the immune reconstitution, or baseline BMI higher baseline LMI was the protective factor of immune reconstitution, baseline FMI and bone mineral content / height and immune reconstitution.

【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;中国医学科学院北京协和医学院北京协和医院感染内科艾滋病诊疗中心;中国人民解放军第309医院核医学科;
【基金】：国家十二五“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项资助项目(2012ZX10001003)(2012-2015)~~
【分类号】：R512.91

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