| 叶润华,段松,项丽芬,杨跃诚,杨忠桔,韩文香,曹东冬,杨建华,李维美,杨锦,王继宝,高洁,龚渝蓉,杨世江,朱萍,何纳.云南省德宏州无抗病毒治疗史的HIV感染者CD4+T淋巴细胞计数自然变化及其影响因素[J].中华流行病学杂志,2011,32(9):882-887 |
| 云南省德宏州无抗病毒治疗史的HIV感染者CD4+T淋巴细胞计数自然变化及其影响因素 |
| Studies on the determinants and changes related to the natural CD4 + T cell counts among antiretroviral treatment-naive HIV/AIDS patients in Dehong prefecture, Yunnan province |
| 收稿日期:2011-03-22 出版日期:2014-09-11 |
| DOI： |
| 中文关键词: 艾滋病病毒 CD4+T淋巴细胞计数 自然变化 影响因素 |
| 英文关键词: HIV CD4+ T cell counts Natural changes Determinants |
| 基金项目:国家“十一五”科技重大专项( 2008ZX 10001-016,2008ZX 10001-003) |
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| 中文摘要: |
| 目的 探讨云南省德宏州HIV感染者在无抗病毒治疗干预下的CD4+T淋巴细胞计数自然变化情况及其影响因素。方法对1989-2010年5月间德宏州报告的当地户籍、无抗病毒治疗史或抗病毒治疗前先后至少接受过2次CD4+T淋巴细胞计数检测的HIV感染者进行回顾性队列研究，描述并比较其末次与首次CD4+T淋巴细胞计数自然变化速率，运用logistic回归分析CD4+T淋巴细胞计数生物学意义显著下降的影响因素。结果共纳入研究对象4487例，CD4+T淋巴细胞计数月均自然变化速率中位数为-2.0 cell/μl(IQR：-8.2～3.6)，并与HIV感染者的人口学特征、感染途径、首次CD4+T淋巴细胞计数、首末次检测间隔等因素有显著关联。约60.0％(2693例)研究对象末次CD4+T淋巴细胞计数低于首次，表现为自然下降。约31.2％( 1400例)研究对象末次CD4+T淋巴细胞计数较首次下降幅度在30％以上，表现为显著下降。Logistic多因素回归分析显示：在控制潜在混杂因素的影响后，HIV感染者CD4+T淋巴细胞计数显著下降与年龄、民族、婚姻状况、感染途径、首次CD4+T淋巴细胞计数水平、首末次CD4+T淋巴细胞计数检测间隔存在统计学关联。结论云南省德宏州HIV感染者CD4+T淋巴细胞计数自然变化总体平缓，但仍有相当部分HIV感染者CD4+T淋巴细胞计数下降显著且与多种因素有关。有必要加强对HIV感染者的定期随访和CD4+T淋巴细胞计数检测以掌握其病情进展状态，适时启动抗病毒治疗。 |
| 英文摘要: |
| Objective To explore the determinants and changes ofCD4+ T cell counts among antiretroviral treatnent-naive HIV/AIDS patients in Dchong prefecture, Yunnan province. Methods<.b> A retrospective cohort analysis was conducted on HIV-infected local residents, being reported during 1989 through May 2010, in Dehong prefecture. The patients had received at least two CD4+ T cell counting tests before receiving the antiretroviral treatment (ART). Difference between the first and the last CD4+ T cell counts was calculated and described. Logistic regression analysis was conducted to examine the determinants of significant depletion of CD4+ T cell counts among them.Results A total of 4487 HIV/AIDS patients were included in the study. The change of CD4 +T cell counts between the first and the last CD4+ T cell count tests had a median of-2.0 cells/μ l in month (IQR: -8.2-3.6) and was significantly associated with socio-demographic characteristics, HIV transmission mode,the first or baseline CD4+ T cell counts and the time interval between the first and the last CD4 + T cell counting tests etc. About 60.0％ (2693/4487) of the HIV/AIDS patients had deletions of CD4+ T cell counts, and 31.2％ (1400/4487) had significant ( ≥ 30％ ) deletions of CD4+ T cell counts. Results from the multiple logistic regression analysis indicated that age, ethnicity,marital status, HIV transmission mode, the first CD4+ T cell counts and the interval between the first and the last CD4+ T cell counting tests were significantly associated with the significant depletion of CD4+ T cell counts. Conclusion The changing rate of CD4+ T cell count among ART-naive local HIV-infected patients in Dehong prefecture, Yunnan province was relatively slow. However,substantial proportion of them showed significant decreases of CD4+ T cell counts, which was determined by many factors. More efforts were needed to systematically and consistently follow-up those HIV-infected patients and measure their CD4+ T cell counts in China, in order to instantaneously monitor the disease progression,and the initiation of ART, if necessary. |
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