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首页> 外文期刊>AIDS care. >One year survival of HIV-infected veterans with CD4 < 100 cells/mm3: data from a veteran cohort.
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One year survival of HIV-infected veterans with CD4 < 100 cells/mm3: data from a veteran cohort.

机译：CD4 <100细胞/ mm3的HIV感染退伍军人的一年生存：来自退伍军人队列的数据。

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Survival among HIV-infected patients markedly improved with the introduction of highly active antiretroviral therapy (HAART). Easier to take and more effective HAART options have improved the one-year virologic success rate among naive patients. Numerous studies have shown that initiating HAART and restoration of CD4 cells positively impact survival. There are only a few evaluations that have been carried out on the changes in survival among patients who are severely immunosuppressed. We evaluated survival among a cohort of veterans with CD4<100 cells/mm(3) (CD4 < 100) in three time periods reflecting early, mid, and recent HAART. Using the HIV clinic database, all patients with CD4 < 100 seen between 1996 and 2004 were identified (n=394). Patients entered Cohorts 1 (n=219), 2 (n=72), and 3 (n=103) in 1996-1998, 1999-2001, and 2002-2004, respectively. Data on demographics, AIDS-defining illnesses, co-morbidities, treatment, CD4, and viral load (VL) were abstracted. Survival analysis controlling for the above variables was performed and odds ratios with 95% confidence intervals were calculated. Rate of virologic suppression was higher for Cohort 2 when compared to Cohort 1 (63% vs. 46%, p<0.05), but lower for Cohort 3 when compared to Cohort 2 (49%, p<0.05). Survival at one year was high for Cohorts 1 and 2 (92-95%), but significantly lower in Cohort 3 (80%). On logistic regression analysis and for the whole cohort, HAART use, achieving a CD4 > 200 and VL<400 were independent predictors of survival. Older age at cohort entry and having a diagnosis of lymphoma, Mycobacterium avium complex infection, coronary artery disease, or renal insufficiency were negative predictors. In the most recent HAART period 2002-2004, one year survival after CD4 < 100 significantly decreased in spite of availability of specialized HIV clinical and support services and antiretrovirals. Our results suggest that more than better drugs are needed for improving survival among certain patient populations with advanced immunosuppression.
机译：引入高活性抗逆转录病毒疗法（HAART），可明显提高HIV感染患者的生存率。更容易服用和更有效的HAART方案提高了天真的患者一年的病毒学成功率。大量研究表明，启动HAART和恢复CD4细胞对存活率产生积极影响。对于严重免疫抑制的患者中存活率的变化，只有很少的评估。我们评估了三个时期的CD4 <100细胞/ mm（3）（CD4 <100）的退伍军人的生存率，反映了早期，中期和近期的HAART。使用HIV诊所数据库，鉴定了1996年至2004年之间发现的所有CD4 <100的患者（n = 394）。在1996-1998年，1999-2001年和2002-2004年，患者分别进入队列1（n = 219），队列2（n = 72）和队列3（n = 103）。提取了有关人口统计学，定义艾滋病的疾病，合并症，治疗，CD4和病毒载量（VL）的数据。进行了控制上述变量的生存分析，并计算了具有95％置信区间的比值比。与队列1相比，队列2的病毒学抑制率更高（63％对46％，p <0.05），而与队列2相比，队列3的病毒学抑制率较低（49％，p <0.05）。组1和组2的一年生存率较高（92-95％），而组3的存活率则明显较低（80％）。在逻辑回归分析和整个队列中，使用HAART可使CD4> 200和VL <400是生存的独立预测因素。队列进入时年龄较大且诊断为淋巴瘤，鸟分枝杆菌复合体感染，冠状动脉疾病或肾功能不全是阴性预测因素。在最近的HAART期间（2002-2004年），尽管可获得专门的HIV临床和支持服务以及抗逆转录病毒药物，但CD4 <100后的一年生存期显着下降。我们的结果表明，要改善某些具有先进免疫抑制作用的患者群体的生存率，还需要更多更好的药物。

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