Gender differences in clinical progression of HIV-1-infected individuals during long-term highly active antiretroviral therapy
Gender differences in clinical progression of HIV-1-infected individuals during long-term highly active antiretroviral therapy
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DOI：
10.1097/01.aids.0000163934.22273.06
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发表时间：
2005-04-08
期刊：
影响因子：
3.8
通讯作者：
Vella, S
中科院分区：
文献类型：
--
作者：
Nicastri, E;Angeletti, C;Vella, S
目的：评价高效抗逆转录病毒疗法(HAART)的长期临床、病毒学和免疫学结果的性别差异。方法：这项多中心的纵向观察性研究跟踪了2460名HIV感染者，他们接受了以蛋白酶抑制剂为基础的治疗方案，中位时间为43个月。结果：与男性相比，690名女性患者(28.0%)的年龄显著低于男性(28.0%)，异性接触发生率明显高于男性，静脉注射毒品的发生率低于男性。此外，女性罹患艾滋病的疾病数量较少，CD4细胞计数较高，病毒载量较低。在患者实现病毒抑制或在实现病毒抑制后表现出反弹的比例方面，没有性别差异的报道。经Kaplan-Meier分析，与男性相比，女性患者在随访期间临床进展较慢(P=0.008)；然而，在调整后的分析中，这种差异并不显着。在多因素模型中，性别与HIV或病毒载量的危险因素之间的交互作用显示，女性吸毒者和基线HIV病毒载量为10(4)-10(5)拷贝/ml的女性患者的临床结果好于男性(分别为P=0.035和P=0.015)。结论：在长期HAART期间，不同性别之间的病毒学和免疫学结果没有差异。然而，据报道，中等基线病毒载量的女性患者的临床进展风险低于男性患者。(C)2005年，里平科特·威廉姆斯·C·威尔金斯。
Objective: To assess gender differences in the long-term clinical, virological and immunological outcomes during highly active antiretroviral therapy (HAART).Methods: This longitudinal observational multicentre study followed 2460 HIV-infected patients who had begun a protease inhibitor-based regimen for a median period of 43 months. Outcome measures were virological suppression (< 500 copies/ml), confirmed virological rebound after suppression, and death or new AIDS-defining illness (ADl).Results: At baseline, 690 female patients (28.0%) had significantly lower age, higher prevalence of heterosexual contact and lower prevalence of intravenous drug use as risk factors for HIV infection compared with males. Furthermore, females had a lower number of AIDS-defining illnesses, higher CD4 cell counts and lower viral loads. No gender differences were reported in terms of proportion of patients achieving viral suppression or exhibiting rebound after achieving viral suppression. Female patients experienced reduced clinical progression during follow-up compared with males (P = 0.008) by Kaplan-Meier analysis; however this difference was not significant in an adjusted analysis. In a multivariate model, the interaction between gender and risk factor for HIV or viral load showed that female drug users and female patients with a baseline HIV RNA viral load of 10(4)-10(5) copies/ml had a favourable clinical outcome compared with males (P = 0.035 and P = 0.015, respectively).Conclusion: No differences were found between genders in terms of virological and immunological outcomes during long-term HAART. Nevertheless, a lower risk of clinical progression was reported among female patients with intermediate baseline viral load than in males. (c) 2005 Lippincott Williams C Wilkins.