湖北省接受艾滋病HAART患者CD4+T淋巴细胞变化趋势及影响因素

目的 分析湖北省接受艾滋病HAART患者CD4⁺T淋巴细胞变化趋势及影响因素。 方法 筛选2012年1月1日以后接受HAART的成年患者,利用一般线性模型、重复测量方差分析来分析患者的基线、治疗后6、12个月的CD4⁺T淋巴细胞计数情况及影响因素。 结果 1 843例研究对象基线CD4⁺T淋巴细胞计数均值为(218.94±143.96)个/μl,接受HAART后6个月为(334.31±188.62)个/μl,12个月后为(382.79±204.44)个/μl,差异有统计学意义(F=6 856.98,P=0.000)。影响HAART治疗后CD4⁺T淋巴细胞计数上升的主要因素是:性别、开始治疗年龄、WHO临床分期、初始治疗方案、基线CD4⁺T淋巴细胞计数。受性别、基线CD4⁺T淋巴细胞计数、开始治疗年龄、初始治疗方案等影响,治疗后CD4⁺T淋巴细胞计数随时间推移呈线性上升趋势;其中,女性、开始治疗年龄越小、基线CD4⁺T淋巴细胞计数越高、初始治疗方案含二线药物的患者上升较快。受WHO临床分期因素影响,治疗后CD4⁺T淋巴细胞计数随时间推移上升趋势符合二次方曲线方程,WHO临床分期越靠前,上升速度较快。 结论 湖北省艾滋病患者接受HAART后CD4⁺T淋巴细胞计数上升受多种因素影响,建议针对不同的患者及早开展HAART,提高抗病毒治疗的效果和患者生命质量。

Changing trend of CD4+T lymphocyte count and its influencing factors in HIV/AIDS patients with HAART in Hubei Province

Objective To analyze the changing trend of CD4⁺T lymphocyte count and its influencing factors in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) in Hubei Province. Methods Adult patients receiving HAART after January 1, 2012 were screened, and the patients’ CD4⁺T lymphocyte counts at baseline and after 6 and 12 months of HAART and their influencing factors were analyzed by the general linear model and repeated measures analysis of variance(ANOVA). Results The mean values of CD4⁺T lymphocyte counts at baseline and after 6 and 12 months of HAART in 1,843 patients were (218.94±143.96)/μl, (334.31±188.62)/μl and (382.79±204.44)/μl respectively, and the differences were statistically significant (F=6,856.98, P=0.000). The main factors affecting the rise of CD4⁺T lymphocyte count after HAART were gender, age of receiving initial therapy, WHO clinical stage, initial treatment plan and baseline CD4⁺T lymphocyte count. Under the influence of gender, baseline CD4⁺T lymphocyte count, age of receiving initial therapy and initial treatment plan, the CD4⁺T lymphocyte count after the therapy increased linearly with time; moreover, the CD4⁺T lymphocyte count in female patients, patients receiving initial therapy at an earlier age, patients with higher baseline CD4⁺T lymphocyte count and patients receiving initial therapy with second-line drugs increased even faster. Under the influence of WHO clinical stage, the rising trend of CD4⁺T lymphocyte count after the therapy was in line with quadratic curve equation. The earlier the WHO clinical stage, the faster the increment. Conclusions The increase of CD4⁺T lymphocyte count in HIV/AIDS patients receiving HAART in Hubei Province is affected by many factors. HAART targeted for different patients should be carried out as early as possible so as to improve the efficacy of antiviral treatment and the quality of life of patients.