Prevalence and Influencing Factors of Immunological Non-response in HIV/AIDS Patients with Second-line Antiretroviral Therapy
Background The lopinavir/ritonavir (LPV/r) -based second-line antiretroviral therapy (ART) has been used for treating HIV/AIDS patients in China for more than 10 years, but post-therapy immunological non-response (INR) in these patients has been rarely studied. Objective To explore the prevalence and influencing factors of post-therapy INR in HIV/AIDS patients switching from first- to second-line ART. Methods Data (including general information and three-year follow-up information after switching to second-line ART) were collected from the Database of TCM Treatment for AIDS and AIDS Prevention and Control Information System, involving 3 016 HIV/AIDS patients (baseline CD4+ T cell count<200 cells/μl) who switched to second-line ART during January 2009 to December 2015. The prevalence of INR was estimated using the follow-up information. Multivariate Logistic regression analysis was performed to investigate the influencing factors of INR. Results The prevalence of INR in the patients after switching to second-line ART during the first, second and third years of follow-up was 42.34% (774/1 828) , 32.31% (608/1 882) , and 24.11% (421/1 746) , respectively. The results of multivariate Logistic regression analysis showed that gender〔female: OR=0.60, 95%CI (0.49, 0.73) 〕 and the baseline CD4+ T cells count〔<50 cells/μl: OR=3.42, 95%CI (2.51, 4.69) ; 50-100 cells/μl: OR=3.26, 95%CI (2.50, 4.27) ; 101-150 cells/μl: OR=1.51, 95%CI (1.19, 1.92) 〕were associated with the prevalence of INR in the first year of follow-up (P<0.05) ; gender〔female: OR=0.70, 95%CI (0.57, 0.86) 〕, age〔40-50 year: OR=1.37, 95%CI (1.05, 1.80) ; >50 year : OR=1.81, 95%CI (1.36, 2.42) 〕, route of infection〔blood: OR=1.40, 95%CI (1.06, 1.85) 〕, duration of HIV positive〔3-6 years: OR=1.48, 95%CI (1.02, 2.13) 〕, duration of HAART therapy before switch to second-line ART〔3-5 year: OR=0.66, 95%CI (0.48, 0.90) ; >5 year: OR=0.71, 95%CI (0.53, 0.95) 〕and baseline CD4+ T cells count〔<50 cells/μl: OR=2.54, 95%CI (1.84, 3.49) ; 50-100 cells/μl: OR=2.49, 95%CI (1.90, 3.27) ; 101-150 cells/μl: OR=1.59, 95%CI (1.23, 2.05) 〕were associated with the prevalence of INR in the second year of follow-up (P<0.05) ; age〔>50 year: OR=1.8, 95%CI (1.31, 2.49) 〕, route of infection〔blood: OR=1.45, 95%CI (1.07, 2.00) 〕, baseline CD4+ T cell count〔<50 cells/μl: OR=2.07, 95%CI (1.52, 2.82) ; 50-100 cells/μl: OR=2.14, 95%CI (1.57, 2.92) ; 101-150 cells/μl: OR=1.49, 95%CI (1.12, 1.98) 〕 were associated with the prevalence of INR in the third year of follow-up (P<0.05) . Conclusion The prevalence of INR in the HIV/AIDS patients after switching to second-line ART during the first, second and third years of follow-up was 42.34%, 32.31%, and 24.11%, respectively. Gender, age, baseline CD4+ T cell counts, infected with HIV via contaminated blood or blood products were the influencing factors of immunological non-response. In addition, immune status is suggested to be specially focused in male patients , aged over 50 years and those the baseline CD4+ T cells count <150 cells/μl..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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Enthalten in: |
Zhongguo quanke yixue - 25(2022), 30, Seite 3789-3795 |
Sprache: |
Chinesisch |
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Beteiligte Personen: |
Dongli WANG, Yanke AI, Jun YUAN, Xiuxia MA, Huijun GUO, Qianlei XU, Yantao JIN [VerfasserIn] |
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Links: |
doi.org [kostenfrei] |
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Themen: |
Aids|lopinavir/ritonavir|second-line highly avtive antiretioviral therapy|immunological non-response|prevalence|root cause analysis |
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doi: |
10.12114/j.issn.1007-9572.2022.0294 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
DOAJ091502284 |
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520 | |a Background The lopinavir/ritonavir (LPV/r) -based second-line antiretroviral therapy (ART) has been used for treating HIV/AIDS patients in China for more than 10 years, but post-therapy immunological non-response (INR) in these patients has been rarely studied. Objective To explore the prevalence and influencing factors of post-therapy INR in HIV/AIDS patients switching from first- to second-line ART. Methods Data (including general information and three-year follow-up information after switching to second-line ART) were collected from the Database of TCM Treatment for AIDS and AIDS Prevention and Control Information System, involving 3 016 HIV/AIDS patients (baseline CD4+ T cell count<200 cells/μl) who switched to second-line ART during January 2009 to December 2015. The prevalence of INR was estimated using the follow-up information. Multivariate Logistic regression analysis was performed to investigate the influencing factors of INR. Results The prevalence of INR in the patients after switching to second-line ART during the first, second and third years of follow-up was 42.34% (774/1 828) , 32.31% (608/1 882) , and 24.11% (421/1 746) , respectively. The results of multivariate Logistic regression analysis showed that gender〔female: OR=0.60, 95%CI (0.49, 0.73) 〕 and the baseline CD4+ T cells count〔<50 cells/μl: OR=3.42, 95%CI (2.51, 4.69) ; 50-100 cells/μl: OR=3.26, 95%CI (2.50, 4.27) ; 101-150 cells/μl: OR=1.51, 95%CI (1.19, 1.92) 〕were associated with the prevalence of INR in the first year of follow-up (P<0.05) ; gender〔female: OR=0.70, 95%CI (0.57, 0.86) 〕, age〔40-50 year: OR=1.37, 95%CI (1.05, 1.80) ; >50 year : OR=1.81, 95%CI (1.36, 2.42) 〕, route of infection〔blood: OR=1.40, 95%CI (1.06, 1.85) 〕, duration of HIV positive〔3-6 years: OR=1.48, 95%CI (1.02, 2.13) 〕, duration of HAART therapy before switch to second-line ART〔3-5 year: OR=0.66, 95%CI (0.48, 0.90) ; >5 year: OR=0.71, 95%CI (0.53, 0.95) 〕and baseline CD4+ T cells count〔<50 cells/μl: OR=2.54, 95%CI (1.84, 3.49) ; 50-100 cells/μl: OR=2.49, 95%CI (1.90, 3.27) ; 101-150 cells/μl: OR=1.59, 95%CI (1.23, 2.05) 〕were associated with the prevalence of INR in the second year of follow-up (P<0.05) ; age〔>50 year: OR=1.8, 95%CI (1.31, 2.49) 〕, route of infection〔blood: OR=1.45, 95%CI (1.07, 2.00) 〕, baseline CD4+ T cell count〔<50 cells/μl: OR=2.07, 95%CI (1.52, 2.82) ; 50-100 cells/μl: OR=2.14, 95%CI (1.57, 2.92) ; 101-150 cells/μl: OR=1.49, 95%CI (1.12, 1.98) 〕 were associated with the prevalence of INR in the third year of follow-up (P<0.05) . Conclusion The prevalence of INR in the HIV/AIDS patients after switching to second-line ART during the first, second and third years of follow-up was 42.34%, 32.31%, and 24.11%, respectively. Gender, age, baseline CD4+ T cell counts, infected with HIV via contaminated blood or blood products were the influencing factors of immunological non-response. In addition, immune status is suggested to be specially focused in male patients , aged over 50 years and those the baseline CD4+ T cells count <150 cells/μl. | ||
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