Please wait a minute...
文章检索
预防医学  2017, Vol. 29 Issue (12): 1189-1192,1198    DOI: 10.19485/j.cnki.issn1007-0931.2017.12.001
  论著 本期目录 | 过刊浏览 | 高级检索 |
MSM人群HIV/AIDS基线CD4水平与艾滋病抗病毒治疗效果的关系研究
郑锦雷1,潘晓红1,马瞧勤1,陈芳2,杨介者1,何林1,徐云1,蒋均1,陈婉君1,罗艳2,张兴亮2,席胜军3
1.浙江省疾病预防控制中心,浙江 杭州 310051;
2.杭州市疾病预防控制中心;
3.杭州市下城区疾病预防控制中心
A study on the association of baseline CD4+T and early antiretroviral therapy effect among MSM HIV/AIDS patients
ZHENG Jin-lei,PAN Xiao-hong,MA Qiao-qin,CHEN Jun-fang,YANG Jie-zhe,HE Lin,XU Yun,JIANG Jun,CHEN Wan-jun,LUO Yan,ZHANG Xing-liang,XI Sheng-jun
Zhejiang Provincial Center for Disease Control and Prevention,Zhejiang,Hangzhou,310051,China
全文: PDF(568 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 分析男男性行为(MSM)人群艾滋病病毒感染者和艾滋病患者(HIV/AIDS)基线CD4+T淋巴细胞(CD4)水平对艾滋病抗病毒治疗效果的影响。方法 于2014年7月1日—2016年6月30日招募杭州市MSM人群初次接受艾滋病抗病毒治疗的HIV/AIDS,将基线CD4≥500/μL定为观察组,<500/μL定为对照组,定期随访并检测CD4和病毒载量,比较两组HIV/AIDS抗病毒治疗效果。结果 共纳入HIV/AIDS 1 206例,其中对照组1 026例,观察组180例。观察组和对照组在治疗随访第12个月时,CD4恢复到719/μL(浙江省正常成人CD4中位数)的比例分别为39.13%和12.50%;第18个月时分别为38.71%和13.75%。观察组CD4首次恢复成功所需的中位时间为7.2个月,少于对照组的20.4个月(P<0.05)。治疗满12个月时,对375例HIV/AIDS进行病毒载量检测,病毒抑制成功(<400 copies/mL)365例,占97.33%。观察组和对照组的病毒抑制成功率分别为96.34%和97.50%,差异无统计学意义(P>0.05)。结论 基线CD4≥500/μL和<500/μL的MSM人群HIV/AIDS抗病毒治疗病毒抑制成功率相近,前者CD4首次恢复用时较短。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
郑锦雷
潘晓红
马瞧勤
陈芳
杨介者
何林
徐云
蒋均
陈婉君
罗艳
张兴亮
席胜军
关键词 艾滋病男男性行为人群抗病毒治疗效果评价    
AbstractObjective To analyze the association between baseline level of CD4+T and the therapeutic effects of highly active antiretroviral therapy (HAART) for MSM HIV/AIDS in Hangzhou City. Methods We recruited MSM HIV/AIDS who initiated HAART from July 1st 2014 to June 30th 2016 into the study in Hangzhou City. MSM HAART patients whose baseline CD4+T≥500 copies/μL was set as observation group,and baseline CD4+T<500 copies/μL was set as control group. Patients were tested CD4 count and viral load regularly. We compared HAART effects of observation group and control group. Results We recruited 1 206 MSM patients with access to HAART in our study in Hangzhou City. And 1 026 patients were set in control group,and 180 patients were set in observation group. In the 12th month,the rates of two groups' patients with CD4 successfully recovered (reached 719 cells/μL)were 12.50% and 39.13%. In the 18th month,the rates were 13.75% and 38.71%. The median time of patients with CD4 first successfully recovered to 719 cells/μL was 7.2 months in observation group,while the median time of control group was 20.4 months,which was longer than observation group(P<0.05). A total of 375 patients were tested viral load,and the successful suppression rate of viral load was 97.33%. The rates of observation and control group were 96.34% and 97.50%(P>0.05). Conclusion The rates of viral successful suppression were similar between baseline CD4 counts ≥500 cells/μL group and<500 cells/μL group among MSM HAART patients. Recovery time in baseline CD4 counts ≥500 cells/μL group was shorter than baseline CD4 counts<500 cells/μL group.
Key wordsAcquired immune deficiency syndrome    Men who have sex with men    Antiretroviral therapy    Evaluation of therapy effects
         
中图分类号:  R512.91  
基金资助:浙江省科技厅重大科技专项重点社会发展项目(2013C03047 -1);浙江省卫生计生委重点项目(2014ZDA034)
通信作者: 杨介者,E-mail:jzhyang@cdc.zj.cn   
作者简介: 郑锦雷,硕士,主管医师,主要从事艾滋病防制工作
引用本文:   
郑锦雷, 潘晓红, 马瞧勤, 陈芳, 杨介者, 何林, 徐云, 蒋均, 陈婉君, 罗艳, 张兴亮, 席胜军. MSM人群HIV/AIDS基线CD4水平与艾滋病抗病毒治疗效果的关系研究[J]. 预防医学, 2017, 29(12): 1189-1192,1198.
ZHENG Jin-lei, PAN Xiao-hong, MA Qiao-qin, CHEN Jun-fang, YANG Jie-zhe, HE Lin, XU Yun, JIANG Jun, CHEN Wan-jun, LUO Yan, ZHANG Xing-liang, XI Sheng-jun. A study on the association of baseline CD4+T and early antiretroviral therapy effect among MSM HIV/AIDS patients. Preventive Medicine, 2017, 29(12): 1189-1192,1198.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn1007-0931.2017.12.001      或      http://www.zjyfyxzz.com/CN/Y2017/V29/I12/1189
[1] 徐云,潘晓红,杨介者,等.浙江省2004—2013年MSM的艾滋病疫情分析[J]. 中国艾滋病性病,2015,21(1):37- 40.
[2] 中华人民共和国国家卫生与计划生育委员会. 国家卫生计生委办公厅关于修订艾滋病患者免费抗病毒治疗标准的通知(国卫办医函〔2014〕326号)[EB/OL].[2017-09-06].
http://www.nhfpc.gov.cn/yzygj/s3593/201405/95edf9ac8abb4e1a 9f3482501b0ae4be.shtml.
[3] 郑锦雷,杨介者,徐云,等. 高效抗逆转录病毒治疗艾滋病方案的效果评价[J]. 浙江预防医学,2010,22(1):5-7.
[4] The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection[J]. N Engl J Med,2015,373(9):795-807.
[5] 郭志宏,姚亚萍,李西婷,等. 浙江地区健康青少年和成人外周血T淋巴细胞免疫表型调查及正常参考值范围的建立[J]. 中国预防医学杂志,2008,9(1):32-35.
[6] 中华人民共和国卫生部艾滋病临床专家工作组.《国家免费艾滋病抗病毒药物治疗手册》[M].4版.北京:人民卫生出版社,2016.
[7] 郑锦雷,徐云,何林,等.浙江省2009—2014年艾滋病抗病毒治疗效果分析[J].中华流行病学杂志,2016,37(5):673-677.
[8] HEYMER K J,WILSON D P. Treatment for prevention of HIV transmission in a localised epidemic:the case for South Australia[J]. Sex Health,2011,8(3):280-294.
[9] SOOD N,WAGNER Z,JAYCOCKS A,et al. Test-and-treat in Los Angeles:a mathematical model of the effects of test-and-treat for the population of men who have sex with men in Los Angeles County[J]. Clin Infect Dis,2013,56(12):1789-1796.
[10]SABIN C A,COOPER D A,COLLINS S,et al. Rating evidence in treatment guidelines:a case example of when to initiate combination antiretroviral therapy (cART) in HIV-positive asymptomatic persons[J]. AIDS,2013,27(12): 1839-1846.
[11]SUN J J,LIU L,SHEN J Y,et al. Trends in baseline CD4 cell counts and risk factors for late antiretroviral therapy initiation among HIV-positive patients in Shanghai,a retrospective cross-sectional study[J]. BMC Infect Dis,2017 ,17(1):285.
[12]魏秀青,张园园,陈曦,等. 湖南省2011年艾滋病患者抗病毒治疗及时性分析[J].中国病毒病杂志,2013,3(1):42-45.
[13]BISHOP J D,DE SHIELDS S,CUNNINGHAM T,et al. CD4 count recovery after initiation of antiretroviral therapy in patients infected with human immunodeficiency virus[J]. Am J Med Sci,2016,352(3):239-244.
[14]GRINSZTEJN B,HOSSEINIPOUR M C,RIBAUDO H J,et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection:results from the phase 3 HPTN 052 randomised controlled trial[J]. Lancet infect Dis,2014,14(4):281-290.
[15]王斌. 艾滋病患者抗病毒治疗前后CD4+T淋巴细胞计数变化[J]. 预防医学,2016,28(5):483-484.
[16]TUAN L E,WRIGHT E J,SMITH D M,et al. Enhanced CD4+ T-Cell Recovery with Earlier HIV-1 Antiretroviral Therapy[J]. N Eng J Med,2013,368(3):218-230.
[17]MELONI S T,CHANG C A,EISEN G,et al. Long-Term Outcomes on Antiretroviral Therapy in a Large Scale-Up Program in Nigeria. P[J]LoS One,2016,11(10):e0164030.
[18]BEER L,BRADLEY H,MATTSON C L,et al. Trends in Racial and Ethnic Disparities in Antiretroviral Therapy Prescription and Viral Suppression in the United States,2009—2013[J]. J Acquir Immune Defic Syndr,2016,73(4):446-453.
[19]LESKO C R,COLE S R,MILLER W C,et al. Ten-year Survival by Race/Ethnicity and Sex Among Treated,HIV-infected Adults in the United States[J]. Clin Infect Dis,2015,60(11):1700-1707.
[20]金玫华,杨中荣,董正全,等. 湖州市艾滋病抗病毒治疗效果分析[J]. 预防医学,2016,28(10):1019-1020.
[1] 俞素芬, 蒋青林, 戴杰. 2012—2021年吴兴区新报告HIV/AIDS病例晚发现及影响因素分析[J]. 预防医学, 2023, 35(9): 796-799.
[2] 郑伟, 张世勇, 杨纶砥, 熊华利. 基于年龄-时期-队列模型的1990—2019年我国艾滋病发病率趋势分析[J]. 预防医学, 2023, 35(8): 665-668,681.
[3] 王婷婷, 汪剡灵, 李桂霞, 常玥. 2012—2021年台州市新报告HIV/AIDS病例首次CD4+T淋巴细胞检测结果分析[J]. 预防医学, 2023, 35(7): 578-582.
[4] 姜海波, 洪航, 周健, 李继革, 史宏博, 谭诗文, 褚堃, 张丹丹. 宁波市HIV/AIDS病例新型毒品使用情况调查[J]. 预防医学, 2023, 35(6): 470-474.
[5] 柏建芸, 赵芳凝, 候金余, 郭燕, 郑敏娜, 李龙, 于茂河. 2005—2021年天津市医疗机构HIV/AIDS检测发现情况分析[J]. 预防医学, 2023, 35(6): 475-479.
[6] 徐亚华, 吴斌. 兰溪市120例HIV抗体筛查阳性样本确证结果分析[J]. 预防医学, 2023, 35(6): 538-540.
[7] 蔺茂文, 刘锐, 张凡, 李舒超, 刘建昭, 豆智慧, 孙春. 1996—2021年荆州市HIV/AIDS病例1年死亡分析[J]. 预防医学, 2023, 35(5): 396-400.
[8] 景正伟, 宁艳, 常文辉, 周超, 任强, 董丽芳, 贾华, 许诗瑶, 王志锋. 高校MSM人群HIV感染学生生存质量分析[J]. 预防医学, 2023, 35(4): 291-294.
[9] 许太彬, 程春荣, 段江洋, 兰培利, 段欣洋. 郑州市50岁及以上HIV/AIDS病例流行特征[J]. 预防医学, 2023, 35(4): 323-326.
[10] 陈银炜, 周洋, 刘珍, 张晓辉. 流动人口HIV感染孕产妇健康综合评价指标体系研究[J]. 预防医学, 2023, 35(3): 210-214.
[11] 蒋均, 陈军仙, 楼莲娟, 朱碧香, 查琏琦, 阮建军. 义乌市2016—2020年报告HIV/AIDS病例流动特征分析[J]. 预防医学, 2023, 35(1): 21-26.
[12] 罗西, 覃世龙, 明方钊, 余庆, 范传刚. 武汉市MSM人群HIV抗体重复检测的影响因素分析[J]. 预防医学, 2022, 34(8): 831-835.
[13] 张鹤美, 高四海, 陈向阳, 叶振淼, 李君, 赵丽娜, 苏德华, 胡文雪, 赖江宜, 陈婉君. 2006—2020年温州市新报告50岁及以上HIV/AIDS病例时空特征分析[J]. 预防医学, 2022, 34(5): 483-486.
[14] 张丽, 姚英, 胡锦峰, 潘忠廉. 上城区艾滋病自愿咨询检测门诊求询者特征及HIV感染情况分析[J]. 预防医学, 2022, 34(2): 161-165.
[15] 何丁玲, 冯世平, 赵霞, 郭利华, 吕春容, 李虹霞, 郭慧, 黄蕾. 艾滋病住院患者焦虑和抑郁情况调查[J]. 预防医学, 2022, 34(2): 166-170,175.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed