深圳市经性途径感染HIV/AIDS疾病进展影响因素分析

目的研究经性途径感染的HIV/AIDS患者疾病进程的影响因素。方法对深圳市280例经性途径感染HIV/AIDS一般情况及HLA-B等位基因型的分布进行研究,分析其与疾病进展相关性。结果 280例经性途径感染HIV/AIDS分为典型进展组(typical progressors,TP) 223例(79.64%),缓慢进展组(slow progressors,SP) 57例(20.36%)。单因素分析结果显示,TP、SP两组性别、户籍、文化程度,婚姻、传播途径、基线CD4水平和HLA-B基因型构成差异有统计学意义(P<0.05)。TP组HLA-BW4/BW4纯合子构成比相对偏低(10.31%vs. 22.81%),HLA-BW6/BW6纯合子构成比(43.05%vs.29.82%)相对偏高。多因素logistic回归分析结果显示性别(OR=0.030,95%CI:0.003~0.278)、文化程度(OR=0.066,95%CI:0.014~0.316)、传播途径(OR=0.222,95%CI:0.049~0.994)、基线CD4(OR=0.002,95%CI:0.000~0.012)和HLA-B基因型(OR=35.845,95%CI:3.309~388.274)是影响疾病病程的因素(P<0.05)。女性、文化程度高、异性传播、基线CD4>500个/μl和HLA-BW4/BW4基因型是延缓经性途径感染HIV/AIDS疾病进展的保护性因素。结论性别、文化程度、传播途径、基线CD4和HLA-B基因型是影响经性途径感染HIV/AIDS疾病病程的因素。

Factors influencing disease progression of sexually-transmittedHIV/AIDS patients in Shenzhen city

Objective To study the factors affecting disease progression of sexually-transmitted HIV/AIDS patients in Shenzhen city. Methods We studied the general situation and distribution of HLA-B genotypes in 280 sexually-transmitted HIV/AIDS patients in Shenzhen city, and analyzed their associations with the disease progression. Results Two hundred and eighty sexually-transmitted HIV/AIDS patients were divided into the typical progressor (TP) group (79.64%, n=223) and the slow progressor (SP) group(20.36%, n=57). Single factor analysis showed that the constituent ratios of gender, household registration, education level, marital status, route of transmission, baseline CD4 level and HLA-B genotype were statistically significant different between the TP group and the SP group (all P<0.05). The constituent ratio of HLA-BW4/BW4 homozygote was relatively lower in the TP group than in the SP group (10.31% vs. 22.81%), while the constituent ratio of HLA-BW6/BW6 homozygote was relatively higher in the TP group than in the SP group (43.05% vs. 29.82%). Multiple logistic regression analysis indicated that sex(OR=0.030, 95%CI=0.003-0.278), education level(OR=0.066,95%CI=0.014-0.316),transmission route(OR=0.222,95%CI=0.049-0.994),baseline CD4(OR=0.002,95%CI=0.000-0.012), and HLA-B genotype (OR=35.845, 95%CI=3.309-388.274) were the factors affecting the disease progression (all P<0.05). Female, higher education level, heterosexual transmission, baseline CD4 > 500 cells/μl and HLA-BW4/BW4 genotypes were protective factors for delaying the disease progression. Conclusions Gender, education level, transmission route, baseline CD4 and HLA-B genotypes are the factors influencing the disease progression of sexually-transmitted HIV/AIDS.