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首页> 外文期刊>AIDS care. >Early immunologic and virologic responses to highly active antiretroviral therapy and subsequent disease progression among HIV-infected injection drug users.
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Early immunologic and virologic responses to highly active antiretroviral therapy and subsequent disease progression among HIV-infected injection drug users.

机译：HIV感染注射吸毒者对高活性抗逆转录病毒疗法的早期免疫学和病毒学反应，以及随后的疾病进展。

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We examined the prevalence and prognostic value of early responses to highly active antiretroviral therapy (HAART) among community-based injection drug users (IDUs) in Baltimore. Virologic (HIV RNA <1000 copies/ml) and immunologic (CD4 >500 cells/ul or increase of 50 cells/ul from the pre-HAART level) responses were examined in the 1st year of HAART initiation. Cox regression was used to examine the effect of early response on progression to new AIDS diagnosis or AIDS-related death. Among 258 HAART initiators, 75(29%) had no response, 53(21%) had a virologic response only, 38(15%) had an immunologic response only and 92(36%) had a combined immunologic and virologic response in the first year of therapy. Poorer responses were observed in those who were older, had been recently incarcerated, reported injecting drugs, had not had a recent outpatient visit and had some treatment interruption within the 1st year of HAART. In multiple Cox regression analysis, the risk of progression was lower in those with combined virologic and immunologic response than in non-responders, (relative hazard [RH], 0.32; 95% confidence interval [CI], 0.17-0.60). Those with discordant responses had reduced risk of progression compared to non-responders but experienced faster progression than those with a combined response, although none of these differences was statistically significant. Early discordant and non response to HAART was common, often occurred in the setting of injection drug use and treatment interruption and was associated with poorer survival. Interventions to reduce treatment interruptions and to provide continuity of HIV care during incarceration among IDUs are needed to improve responses and subsequent survival.
机译：我们在巴尔的摩社区注射吸毒者（IDU）中检查了对高效抗逆转录病毒疗法（HAART）的早期反应的患病率和预后价值。在HAART开展的第一年，检查了病毒学（HIV RNA <1000拷贝/毫升）和免疫学（CD4> 500细胞/ ul或从HAART前水平增加50细胞/ ul）应答。 Cox回归用于检查早期反应对新的AIDS诊断或AIDS相关死亡进展的影响。在258例HAART引发剂中，有75例（29％）没有反应，只有53例（21％）只有病毒学反应，有38例（15％）只有免疫反应，而92例（36％）有免疫反应和病毒学反应。治疗的第一年。在HAART的第一年内，那些年龄较大，最近被监禁，报告了注射药物，最近没有门诊就诊且治疗中断的患者中观察到的反应较差。在多重Cox回归分析中，合并病毒学和免疫学应答者的进展风险低于无应答者（相对危险度[RH]为0.32; 95％置信区间[CI]为0.17-0.60）。与无反应者相比，反应不协调者的进展风险降低，但与合并反应者相比进展更快，尽管这些差异均无统计学意义。对HAART的早期不一致和无反应是常见的，通常发生在注射药物使用和治疗中断的情况下，并且与较差的生存有关。需要采取干预措施以减少治疗中断，并在注射毒品使用者之间在监禁期间提供艾滋病毒护理的连续性，以改善反应和随后的生存。

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