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首页> 外文期刊>AIDS Research and Human Retroviruses >Rate and predictors of non-AIDS events in a cohort of HIV-infected patients with a CD4 T cell count above 500 cells/mm3
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Rate and predictors of non-AIDS events in a cohort of HIV-infected patients with a CD4 T cell count above 500 cells/mm3

机译：CD4 T细胞计数高于500细胞/ mm3的一组HIV感染患者中非艾滋病事件的发生率和预测因素

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The reduction of risk of non-AIDS events after combined antiretroviral therapy (cART) initiation and the crude incidence rate (CIR) of these events in patients who control the viral load without cART (controllers) in a cohort of 574 antiretroviral-naive patients with a baseline CD4 T cell count above 500 cells/mm3 were assessed. Non-AIDS severe events were defined as a first admission to the hospital due to non-AIDS-defining malignancies, cardiovascular, neuropsychiatric, liver-related, or end-stage renal disease events. Potential determinants of non-AIDS/death events were studied using Cox regression models. Eighty-five non-AIDS/death events occurred during 6,062 persons-years of follow-up (PYFU) with a CIR of 1.4 per 100 PYFU. Factors associated with non-AIDS/death event were age (HR 3.4; 95% CI: 1.6-6.9), nadir CD4 below 350 cells/mm3 (HR 2.5; 95% CI: 1.4-4.6), and a last determination of viral load above the median (HR 1.9; 95% CI: 1.0-3.3). The CIR of non-AIDS/death events was 2.1 and 1.8 per 100 PYFU before and after cART in patients who started cART (n=446). A reduction of CIR of non-AIDS events after cART initiation was observed only in patients with a nadir of CD4 above 350 cells/mm3 (2.5 vs. 0.6 per 100 PYFU, p=0.004, and remained stable after cART in patients with a median nadir of CD4 below 350 cells/mm 3. CIR was similar in elite, viremic, and noncontrollers (1.1, 1.0, and 1.5 per 100 PYFU, respectively, p=0.25). Reduction of CIR of non-AIDS events after cART initiation depends on nadir CD4 T cell count. Most of the controllers patients had a CIR similar to noncontrollers. These data support the early initiation of cART in HIV-infected patients.
机译：在574名未接受过抗逆转录病毒治疗的初治患者中，在没有cART的情况下控制病毒载量的患者（控制者）中，开始联合抗逆转录病毒治疗（cART）后非艾滋病事件的风险降低，以及这些事件的粗略发生率（CIR）。评估基线CD4 T细胞计数高于500细胞/ mm3。非艾滋病严重事件定义为因非艾滋病定义的恶性肿瘤，心血管，神经精神病学，肝脏相关或终末期肾脏疾病事件而首次入院。使用Cox回归模型研究了非艾滋病/死亡事件的潜在决定因素。在6,062人年的随访期间（PYFU）发生了85次非艾滋病/死亡事件，其CIR为每100 PYFU 1.4。与非艾滋病/死亡事件相关的因素包括年龄（HR 3.4; 95％CI：1.6-6.9），最低CD4低于350细胞/ mm3（HR 2.5; 95％CI：1.4-4.6）以及病毒的最后测定高于中位数（HR 1.9; 95％CI：1.0-3.3）。在开始cART的患者中，非艾滋病/死亡事件的CIR为cART前后cP为2.1和每100 PYFU 1.8（n = 446）。仅在CD4最低点高于350个细胞/ mm3的患者中观察到cART启动后非艾滋病事件的CIR降低（每100 PYFU为2.5 vs. 0.6，p = 0.004，在中位患者中，在接受cART后其保持稳定低于350细胞/ mm 3的CD4最低点3.精英，病毒血症和非控制者的CIR相似（分别为每100 PYFU 1.1、1.0和1.5，p = 0.25）。在最低点CD4 T细胞计数方面，大多数控制者患者的CIR与非控制者相似，这些数据支持在HIV感染患者中尽早启动cART。

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