苏州市男男性行为人群艾滋病抗病毒治疗疗效分析

目的 评价苏州市经男男同性性行为感染艾滋病病毒(HIV)者(MSM感染者)抗病毒治疗的效果。方法 收集于2005-2014年接受艾滋病抗病毒治疗的MSM感染者随访数据,分析其HIV病毒抑制、免疫学应答和生存情况。结果 接受治疗的MSM感染者共735例,平均年龄为(36.5±10.5)岁。治疗后12、24、36和48个月的累积生存率分别为0.99、0.97、0.97和0.97。治疗后免疫应答比例为88.0%,CD₄⁺T淋巴细胞计数平均增长161个/mm³,治疗时间在12个月内(OR:0.30,95%CI:0.16,0.55)、13~24个月内者(OR:0.43,95%CI:0.23,0.84),免疫学应答比例低于治疗24个月以上者。治疗后86.8%的MSM感染者病毒完全抑制,治疗时间在12个月内(OR:0.31,95%CI:0.14,0.66)、13~24个月内者(OR:0.39,95%CI:0.21,0.74)病毒完全抑制比例低于治疗24个月以上者。结论 苏州市MSM感染者抗病毒治疗疗效较好,应加强服药初期感染者的管理和监测,以进一步提高治疗效果。

Curative effect analysis on AIDS antiviral treatment among MSM in Suzhou City

Objective To investigate the survival rate, virological and immunological outcome of HIV-positive men who have sex with men (MSM) under antiretroviral therapy (ART) in Suzhou City. Methods A retrospective analysis was conducted on HIV-positive MSM receiving ART between 2005 and 2014. Results A total of 735 MSM, with an average age of 36.5, received ART in Suzhou. The cumulative survival rates at 12, 24, 36 and 48 months after therapy were 0.99, 0.97, 0.97 and 0.97, respectively. After ART, CD4 cell counts increased with an average of 161 cells/mm³, and 88.0% maintained immune responses. Those receiving therapy less than 12 months (OR:0.30,95%CI:0.16, 0.55), within 13-24 months (OR:0.43,95%CI:0.23,0.84) were less likely to achieve immune recovery than those above 24 months of therapy. And 86.8% of the total achieved an undetectable viral load after ART. Those receiving ART less than 12 months (OR:0.31,95%CI:0.14, 0.66), within 13-24 months (OR:0.39,95%CI:0.21,0.74) were less likely to achieve viral suppression. Conclusion ART in HIV-positive MSM is largely effective in prolonging lives, suppressing viral load and immune reconstitution. Efforts should be made to manage and monitor subjects receiving ART within 24 months.