HIV感染者接受长期抗病毒治疗后CD4<sup>+</sup>T平台期水平及影响因素分析

姜海东; 袁婧; 漆维炜; 何坤; 杨红红; 刘敏

doi:10.16016/j.2097-0927.202205085

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HIV感染者接受长期抗病毒治疗后CD4⁺T平台期水平及影响因素分析

临床医学 | 更新时间：2026-01-09

- HIV感染者接受长期抗病毒治疗后CD4⁺T平台期水平及影响因素分析
- Plateaued CD4⁺ T count and its influencing factors in HIV infected patients after long-term antiviral treatment
- 陆军军医大学学报 2023年45卷第1期页码：54-59
- 作者机构：
  
  400036 重庆，重庆市公共卫生医疗救治中心
- 作者简介：
  
  [ 刘敏，E-mail：gwzxliumin@foxmail.com LIU Min, E-mail: gwzxliumin@foxmail.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202205085
  中图分类号： R181.35;R392.3;R512.91
- 收稿：2022-05-16，
  
  修回：2022-09-09，
  
  纸质出版：2023-01-15
- 稿件说明：
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姜海东, 袁婧, 漆维炜, 等. HIV感染者接受长期抗病毒治疗后CD4⁺T平台期水平及影响因素分析[J]. 陆军军医大学学报, 2023,45(1):54-59.

Haidong JIANG, Jing YUAN, Weiwei QI, et al. Plateaued CD4⁺ T count and its influencing factors in HIV infected patients after long-term antiviral treatment[J]. Journal of Army Medical University, 2023, 45(1): 54-59.
姜海东, 袁婧, 漆维炜, 等. HIV感染者接受长期抗病毒治疗后CD4⁺T平台期水平及影响因素分析[J]. 陆军军医大学学报, 2023,45(1):54-59. DOI： 10.16016/j.2097-0927.202205085.

Haidong JIANG, Jing YUAN, Weiwei QI, et al. Plateaued CD4⁺ T count and its influencing factors in HIV infected patients after long-term antiviral treatment[J]. Journal of Army Medical University, 2023, 45(1): 54-59. DOI： 10.16016/j.2097-0927.202205085.

摘要

目的

了解人类免疫缺陷病毒(human immunodeficiency virus，HIV)感染者长期接受抗逆转录病毒治疗(antiretroviral therapy，ART)后CD4

T进入平台期水平及影响因素。

方法

以重庆市公共卫生医疗救治中心感染科诊治，截止2021年12月连续ART超过8年且HIV RNA＜200拷贝/mL患者为研究对象，回顾性收集年龄、ART方案、各时间点CD4

T计数等，统计CD4

T增长，分析影响平台期CD4

T的因素。

结果

纳入766例ART超过8年患者，平台期CD4

T中位数394.0(292.0

507.0)个/μL，其中66例(8.6%)为重度免疫重建不良(suboptimal immune responders，SIR)，CD4

T＜200个/μL；458例(59.8%)≥350个/μL，198例(25.8%)≥500个/μL。以基线CD4

T分组(CD4

T＜200，200~349，350~499，≥500个/μL)，各组平台期CD4

T及较基线增长值均存在统计学差异(

0.05)。以年龄分组，青少年平台期CD4

T 403(306

519)个/μL，显著高于中老年组(

0.05)。单因素分析

显示重度SIR组年龄大于44岁患者占比显著高于非重度SIR组(

0.01)，基线CD4

100个/μL患者占比重度SIR组(54.5%)显著高于非重度SIR组(17.6%，

0.05)。多因素分析显示年龄＞44岁(

=2.061，95%

: 1.157~3.672)、基线CD4

T＜100个/μL(

=4.803，95%

: 2.767~8.340)与平台期重度SIR相关(

0.05)。

结论

本组HIV感染者平台期CD4

T普遍较低，中年与老年患者启动ART时基线CD4

T低于100个/μL发生平台期重度SIR的风险更大；早筛查、早治疗是防控重度SIR发生的关键。

Abstract

Objective

To investigate the plateaued count of CD4

T cells in human immunodeficiency virus (HIV)-infected patients after long-term antiretroviral therapy (ART) and its influencing factors.

Methods

All HIV-infected patients receiving continuous ART for

8 years till December 2021 and with HIV RNA

200 copies/mL in the Infection Department of Chongqing Public Health Medical Treatment Center were recruited and subjected as research object. Their age

ART scheme and CD4

T count at each time point were collected retrospectively

the growth of CD4

T count was counted

and the factors affecting CD4

T count in the plateau stage were analyzed.

Results

A total of 766 patients who receiving ART for longer than 8 years were included in this study. The median plateaued count of CD4

T cells was 394.0 (292.0

507.0)/μL. There were 66 (8.6%) patients of suboptimal immune responders (SIR) with CD4

T count

200/μL

458 (59.8%) with the count ≥350/μL

and 198 (25.8%) ≥500/μL. Based on baseline CD4

T count (

200

200~349

350~499

and ≥500/μL)

the patients were divided into 4 groups and significant differences were seen in CD4

T count and its increase from baseline in each group (

0.05). The teenager group had obviously higher pl

ateaued count of CD4

T cells [403 (306

519)/μL

]

than the middle-aged and elderly group (

0.05). Univariate analysis showed that the proportion of patients older than 44 years was notably larger (

0.01)

and that of patients with baseline CD4

T count

100/μL was also higher (54.5%

17.6%

0.05) in the severe SIR group than the non-severe SIR group. Multivariate analysis indicated that age over 44 years old (

=2.061

95%

: 1.157~3.672) and baseline CD4

T count

100/μL (

=4.803

95%

: 2.767~8.340) were associated with severe SIR in plateau stage (

0.05).

Conclusion

The plateaued count of CD4

T cells in HIV-infected patients is generally low in plateau stage. In middle-aged and elderly patients

those with baseline CD4

T count

100/μL at initiation of ART is at higher risk for severe SIR in plateau stage. Early screening and early treatment are the key points to prevent and control the occurrence of severe SIR.

关键词

Keywords

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HIV感染者接受长期抗病毒治疗后CD4+T平台期水平及影响因素分析

Plateaued CD4+ T count and its influencing factors in HIV infected patients after long-term antiviral treatment

DOI：10.16016/j.2097-0927.202205085

摘要

Abstract

关键词

Keywords

references

HIV感染者接受长期抗病毒治疗后CD4⁺T平台期水平及影响因素分析

Plateaued CD4⁺ T count and its influencing factors in HIV infected patients after long-term antiviral treatment