| 陈妮,江河,陈欢欢,朱秋映,吴秀玲,李剑军,梁能秀,孟琴,刘玄华,黄精华,侯文宣,王昭荃,蓝光华.广西壮族自治区2005-2021年抗病毒治疗男男性行为人群HIV感染者免疫重建及影响因素分析[J].中华流行病学杂志,2024,45(4):529-535 |
| 广西壮族自治区2005-2021年抗病毒治疗男男性行为人群HIV感染者免疫重建及影响因素分析 |
| Immune reconstitution and influencing factors in HIV infected men who have sex with men with access to antiviral therapy in Guangxi Zhuang Autonomous Region from 2005 to 2021 |
| 收稿日期:2023-07-19 出版日期:2024-04-17 |
| DOI：10.3760/cma.j.cn112338-20230719-00021 |
| 中文关键词: 男男性行为人群 艾滋病 抗病毒治疗 免疫重建 |
| 英文关键词: Men who have sex with men AIDS Antiviral therapy Immune reconstitution |
| 基金项目:国家自然科学基金（82160636） |
| 作者 | 单位 | E-mail | | 陈妮 | 右江民族医学院公共卫生与管理学院, 百色 533000 | | | 江河 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 陈欢欢 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 朱秋映 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 吴秀玲 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 李剑军 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 梁能秀 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 孟琴 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 刘玄华 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 黄精华 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | | | 侯文宣 | 广西中医药大学, 南宁 530028 | | | 王昭荃 | 广西中医药大学, 南宁 530028 | | | 蓝光华 | 广西壮族自治区疾病预防控制中心, 南宁 530028 | lgh605@163.com |
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| 中文摘要: |
| 目的 分析广西壮族自治区（广西）抗病毒治疗（ART）的MSM中HIV感染者（MSM感染者）实现免疫重建的比例及影响因素。方法 资料来源于中国疾病预防控制信息系统，研究对象为2005-2021年广西首次接受ART≥24周MSM感染者，并维持24个月内HIV RNA低于检测限。计算其接受ART后免疫重建的比例，采用Cox比例风险回归模型分析其免疫重建的影响因素。采用SPSS 24.0软件进行统计学分析。结果 在3 200例MSM感染者中，免疫重建不良、中等免疫重建和完全免疫重建的比例分别为15.56%（498/3 200）、14.78%（473/3 200）和69.66%（2 229/3 200）。免疫重建的ART时间M（Q1，Q3）为12（5，27）个月。多因素Cox比例风险回归模型分析结果显示，相比于开始ART年龄≥30岁、WHO临床分期为Ⅲ期/Ⅳ期、基线BMI<18.50 kg/m2和基线CD4+T淋巴细胞（CD4）计数<200个/µl者，开始ART年龄<30岁、WHO临床分期为Ⅰ期/Ⅱ期、基线BMI≥24.00 kg/m2和基线CD4计数≥200个/µl者更容易实现完全免疫重建。结论 2005-2021年广西ART的MSM感染者存在一定比例的免疫重建不良者，应针对年龄较大者和基线CD4计数较低者等重点人群调整和优化ART方案及监测。 |
| 英文摘要: |
| Objective To analyze immune reconstitution and influencing factors in HIV infected men who have sex with men (MSM) with access to antiviral therapy (ART) in Guangxi Zhuang Autonomous Region (Guangxi) during 2005-2021. Methods The data were collected from Chinese Disease Prevention and Control Information System. The study subjects were HIV infected MSM with access to the initial ART for ≥24 weeks in Guangxi from 2005 to 2021 and HIV RNA lower than the detection limit within 24 months. The proportion of infected MSM who had immune reconstitution after ART was calculated. Cox proportional hazard regression model was used to analyze the influencing factors of immune reconstitution. Software SPSS 24.0 was used for statistical analysis.Results A total of 3 200 HIV infected MSM were enrolled, in whom 15.56 % (498/3 200) had no immune reconstitution, 14.78% (473/3 200) had moderate immune reconstitution, and the rate of complete immune reconstitution was 69.66% (2 229/3 200). The M (Q1, Q3) of ART time for immune reconstitution was 12 (5, 27) months. Multivariate Cox proportional risk regression model analysis results showed that compared with those with initial ART at age ≥30 years, WHO clinical stage Ⅲ/Ⅳ illness, baseline BMI <18.50 kg/m2 and baseline CD4+T lymphocyte (CD4) counts <200 cells/µl, HIV infected MSM with initial ART at age <30 years, WHO clinical stageⅠ/Ⅱ illness, baseline BMI≥24.00 kg/m2 and baseline CD4 counts ≥200 cells/µl were more likely to have complete immune reconstitution. Conclusions In the HIV infected MSM in Guangxi, failures to achieve moderate and complete immune reconstitution were observed. Surveillance and ART regimen should be improved for key populations, such as those with older age and low baseline CD4 counts. |
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