Analysis of serious non-AIDS events among HIV-infected adults at Latin American sites
Analysis of serious non-AIDS events among HIV-infected adults at Latin American sites
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DOI：
10.1111/j.1468-1293.2010.00824.x
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发表时间：
2010-10-01
期刊：
影响因子：
3
通讯作者：
Losso, M. H.
中科院分区：
文献类型：
--
作者：
Belloso, W. H.;Orellana, L. C.;Losso, M. H.
目的获得性免疫缺陷似乎与严重的非艾滋病 (SNA) 定义的疾病有关，例如心血管疾病、肝肾功能不全以及非艾滋病相关的恶性肿瘤。我们分析了拉丁美洲回顾性队列中几个 SNA 事件的发生率和相关因素。材料和方法记录了队列患者中 SNA 事件的病例。从有风险的队列成员中为每个病例选择三个对照。采用条件逻辑模型来估计传统危险因素以及 HIV 相关因素对非 AIDS 定义病症的影响。 结果 在 6007 名随访患者中，130 例发生 SNA 事件（0.86 次事件/100 人年随访）并被定义为病例（40 例有心血管事件，54 例有严重肝功能衰竭，35 例有非 AIDS 定义的恶性肿瘤，2 例有肾病）不足）。正如预期的那样，糖尿病、乙型和丙型肝炎病毒合并感染以及酗酒等危险因素与事件存在关联。病例组在索引日期前最后记录的 CD4 T 细胞计数（P=0.0056，平均差异超过 100 个细胞/μL）和索引日期前一年的 CD4 细胞曲线下面积（P=0.0081）显着低于对照组。索引日期的 CD4 细胞计数与调整危险因素后的结果显着相关。 结论 在该拉丁美洲队列中发现的 SNA 事件的发生率和类型与其他地区报告的相似。我们发现免疫缺陷与 SNA 事件风险之间存在显着关联，即使在接受抗逆转录病毒治疗的患者中也是如此。
ObjectiveAcquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort.Materials and methodsCases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV-associated factors on non-AIDS-defining conditions.ResultsAmong 6007 patients in follow-up, 130 had an SNA event (0.86 events/100 person-years of follow-up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non-AIDS-defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T-cell count prior to index date (P=0.0056, with an average difference of more than 100 cells/mu L) and area under the CD4 cell curve in the year previous to index date (P=0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors.ConclusionsThe incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.