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首页> 外文期刊>AIDS care. >Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts
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Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts

机译：接受抗逆转录病毒治疗的男性和女性艾滋病毒患者在疾病进展和死亡率方面是否存在差异？观察性队列的荟萃分析

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Studies examining the sex differences in morbidity and mortality among HIV/AIDS patients have yielded inconsistent results. We conducted a meta-analysis of sex differences in disease progression and mortality among HIV/AIDS patients. Medical literature databases from inception to August 2014 were searched for published observational studies assessing sex differences in immunologic and virologic response, disease progression and mortality among HIV-infected patients. Random effects meta-analyses of 115 eligible studies were conducted to obtain pooled estimates of outcomes and heterogeneity was explored in sub-group analyses. Pooled estimates showed an increased risk of progression to AIDS (relative risk [RR]=1.11,95% CI=1.02-1.21) and all-cause mortality (RR=1.23, 95% CI=1.17-1.29) among males compared to females. All-cause mortality differed by sex only in low and middle income countries. The risk of AIDS-related mortality (RR=1.03, 95% CI=0.82-1.30), immunologic failure (RR=1.19,95% CI: 0.97-1.47), virologic suppression (RR=0.98, 95% CI=0.84-1.14), virologic failure (RR=1.26, 95% CI=0.99-1.61) and the change in CD4 cell count (Weighted mean difference [WMD] = -5.15, 95% CI= -13.57 to 3.28) did not differ by sex. These findings were modified by disease severity, adherence and use of highly active antiretroviral therapy. We conclude that HIV-related disease progression and survival outcomes are poorer in males.
机译：检验艾滋病毒/艾滋病患者发病率和死亡率性别差异的研究结果不一致。我们对艾滋病毒/艾滋病患者在疾病进展和死亡率方面的性别差异进行了荟萃分析。搜索从开始到2014年8月的医学文献数据库，以获取已发表的观察性研究，以评估HIV感染患者在免疫和病毒学应答，疾病进展和死亡率方面的性别差异。进行了115项合格研究的随机效应荟萃分析，以获取结果的汇总估计，并在亚组分析中探讨了异质性。汇总估计值显示，与女性相比，男性患艾滋病的风险增加（相对风险[RR] = 1.11,95％CI = 1.02-1.21），全因死亡率（RR = 1.23，95％CI = 1.17-1.29） 。全因死亡率仅在低收入和中等收入国家中因性别而异。艾滋病相关死亡风险（RR = 1.03，95％CI = 0.82-1.30），免疫学衰竭（RR = 1.19,95％CI：0.97-1.47），病毒学抑制（RR = 0.98，95％CI = 0.84- 1.14），病毒学衰竭（RR = 1.26、95％CI = 0.99-1.61）和CD4细胞计数的变化（加权平均差异[WMD] = -5.15、95％CI = -13.57至3.28）没有性别差异。这些发现因疾病严重程度，依从性和使用高效抗逆转录病毒疗法而被修改。我们得出的结论是，与艾滋病毒有关的疾病进展和生存结果在男性中较差。

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