Baseline CD4+ Cell Count, Not Viral Load, Correlates With Virologic Suppression Induced by Potent Antiretroviral Therapy
Baseline CD4+ Cell Count, Not Viral Load, Correlates With Virologic Suppression Induced by Potent Antiretroviral Therapy
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基线 CD4 细胞计数（而非病毒载量）与强效抗逆转录病毒治疗引起的病毒抑制相关
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
E. M. Obee
中科院分区：
文献类型：
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作者：
G. Skowron;J. Street;E. M. Obee
目的：探讨病毒载量抑制与基线病毒载量之间以及病毒载量抑制与基线CD4+细胞计数之间的关系。设计：对已发表和提出的研究进行荟萃分析。方法：荟萃分析中纳入了两种核苷类似物联合奈韦拉平、茚地那韦、奈非那韦或依非韦伦治疗未接受过抗逆转录病毒治疗且随访至少 6 个月的 HIV 感染或 AIDS 患者的试验。将 6 个月和 12 个月时病毒载量 <200-500 拷贝/ml 的患者比例（患者总数分别为 1619 例和 761 例）回归到平均或中位基线病毒载量和 CD4+ 细胞计数。结果：从 30 项研究中确定了 36 个治疗组。多变量回归显示基线 CD4+ 细胞计数与 6 个月和 12 个月时的病毒学抑制之间存在显着相关性（分别为 t = 2.85，p = .008；和 t = 3.08，p = .010），但基线病毒载量与病毒学抑制之间不存在显着相关性（分别为 t = 0.92，p = .365；和 t = 1.31，p = .215）。在含奈韦拉平治疗试验的亚组分析中也发现了相同的模式（6 个月时 CD4+ 细胞计数：t = 2.89，p = .014；病毒载量抑制：t = 0.84，p = .415）。结论：与基线病毒载量相比，基线 CD4+ 细胞计数是三联疗法诱导的病毒学抑制的更好预测指标。
Objective: To investigate the relationship between viral load suppression and baseline viral load as well as that between viral load suppression and baseline CD4+ cell count. Design: Meta‐analysis of published and presented studies. Methods: Trials of two nucleoside analogs plus nevirapine, indinavir, nelfinavir, or efavirenz as therapy for antiretroviral treatment‐naive patients with HIV infection or AIDS who were followed‐up for at least 6 months were included in the meta‐analysis. The proportion of patients with viral loads of <200‐500 copies/ml at 6 and 12 months (total number of patients, 1619 and 761, respectively) was regressed to the mean or median baseline viral load and CD4+ cell count. Results: Thirty‐six treatment arms from 30 studies were identified. Multivariate regression demonstrated a significant correlation between baseline CD4+ cell count and virologic suppression at 6 and 12 months (t = 2.85, p = .008; and t = 3.08, p = .010, respectively) but not between baseline viral load and virologic suppression (t = 0.92, p = .365; and t = 1.31, p = .215, respectively). The same pattern was seen in a subanalysis of trials of nevirapine‐containing therapy (CD4+ cell count: t = 2.89, p = .014 at 6 months; viral load suppression: t = 0.84, p = .415). Conclusions: Baseline CD4+ cell count was a better predictor of virologic suppression induced by triple combination therapy than was baseline viral load.