文章摘要
王继宝,陈凯,赫晓霞,龚渝蓉,杨锦,段星,王译葵,杨跃诚,叶润华,蒋岩,段松,邢文革.HIV-1感染者抗病毒治疗后HIV-1 DNA载量动力学变化及影响因素分析[J].中华流行病学杂志,2022,43(5):692-695
HIV-1感染者抗病毒治疗后HIV-1 DNA载量动力学变化及影响因素分析
Dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy
收稿日期:2021-11-29  出版日期:2022-05-13
DOI:10.3760/cma.j.cn112338-20211129-00922
中文关键词: 艾滋病病毒;抗病毒治疗;脱氧核糖核酸;载量
英文关键词: HIV;Antiretroviral therapy;DNA;Load
基金项目:国家科技重大专项(2018ZX10732101-001-010)
作者单位E-mail
王继宝 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
陈凯 北京祥瑞生物制品股份有限公司, 北京 101407  
赫晓霞 北京市理化分析测试中心/北京市食品安全分析测试工程技术研究中心/北京市基因测序与功能分析工程技术研究中心, 北京 100089  
龚渝蓉 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
杨锦 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
段星 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
王译葵 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
杨跃诚 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
叶润华 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
蒋岩 中国疾病预防控制中心性病艾滋病预防控制中心参比实验室, 北京 102206  
段松 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
邢文革 中国疾病预防控制中心性病艾滋病预防控制中心参比实验室, 北京 102206 xingwenge@sina.com 
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中文摘要:
      目的 分析云南省德宏傣族景颇族自治州(德宏州)HIV感染者抗病毒治疗后HIV-1 DNA载量的动力学变化及影响因素,为HIV-1 DNA定量检测的临床应用提供参考依据。方法 研究对象来源于德宏州CDC建立的2009-2018年HIV新发感染队列,构建HIV-1 DNA载量随抗病毒治疗时间动力学变化曲线图。采用logistics回归模型进行抗病毒治疗后最近1次随访的HIV-1 DNA载量值的影响因素分析。采用SPSS 17.0软件进行统计学分析。结果 新发队列113例HIV感染者中,HIV新发感染者占49.6%(56/113),男性、性传播和注射吸毒传播分别占53.1%(60/113)、80.5%(91/113)和19.5%(22/113)。抗病毒治疗前,HIV-1 DNA载量值较高(>800 拷贝/106 PBMCs);抗病毒治疗1年后,HIV-1 DNA载量值迅速下降至<400 拷贝/106 PBMCs;随着抗病毒治疗的持续进行,HIV-1 DNA载量值下降不明显,第6年载量值仍维持在269 拷贝/106PBMCs。进行HIV-1感染者抗病毒治疗后最近1次随访HIV-1 DNA载量值的影响因素分析,单因素logistics回归分析结果显示,基线CD8、基线CD4/CD8和基线HIV-1 DNA载量值OR值(95%CI)分别为1.00(1.00~1.00)、0.30(0.09~1.05)和1.01(1.00~1.01),多因素logistics回归分析结果显示,基线HIV-1 DNA载量值的OR值(95%CI)为1.00(1.00~1.01)。结论 在抗病毒治疗后第1年内,HIV-1 DNA载量值下降显著,随后下降到一定水平之后保持稳定,该水平与HIV-1 DNA载量值基线密切相关,基线越低,HIV-1 DNA载量值水平越低。感染HIV后尽早开始抗病毒治疗,有利于控制HIV-1 DNA载量值。
英文摘要:
      Objective To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /106 PBMCs) before ART, and droped rapidly (<400 copies /106 PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/106 PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed thatOR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusion HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.
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