CD4+ T cell count recovery in HIV type 1-infected patients is independent of class of antiretroviral therapy
CD4+ T cell count recovery in HIV type 1-infected patients is independent of class of antiretroviral therapy
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DOI：
10.1086/592113
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发表时间：
2008-10-15
影响因子：
11.8
通讯作者：
Kaufmann, Gilbert R.
中科院分区：
文献类型：
--
作者：
Khanna, Nina;Opravil, Milos;Kaufmann, Gilbert R.
背景。近年来，人类免疫缺陷病毒1型（HIV-1）感染的治疗选择已从非增强型蛋白酶抑制剂（PI）转向非核苷类逆转录酶抑制剂（NNRTIs）以及基于PI的增强型抗逆转录病毒药物治疗方案，但对免疫恢复的影响仍不确定。 1996 年 1 月至 2007 年 5 月期间，瑞士 HIV 队列中的所有患者如果接受了第一次联合抗逆转录病毒治疗 (cART) 并且已知基线 CD4(+) T 细胞计数和 HIV1 RNA 值，则被纳入其中 (n=3293)。平均（+/- SD）随访时间为数月。随访时间仅限于第一次 cART 的持续时间。在 3 个不同的治疗组中分析了 CD4(+) T 细胞的恢复情况：非加强型 PI、NNRTI 或加强型 PI。终点是开始 cART 后 3 个治疗组中 CD4(+) T 细胞计数的绝对增加。结果。 2590 人 (78.7%) 开始了非加强 PI 方案，452 人 (13.7%) 开始了 NNRTI 方案，251 人 (7.6%) 开始了加强 PI 方案。 48 个月时绝对 CD4(+) T 细胞计数增加如下：在非加强-PI 组中，从 210 个细胞/mL 增加到 520 个细胞/mL； NNRTI 组为 220 至 475 个细胞/mL；在增强 PI 组中，从 168 个细胞/mL 增加到 511 个细胞/mL。在多变量分析中，治疗组不影响CD4(+) T细胞的反应；然而，年龄增加、核苷逆转录酶抑制剂预处理、丙型肝炎病毒血清学检测呈阳性、疾病控制和预防中心C级感染、较低基线CD4(+) T细胞计数和较低基线HIV-1 RNA水平是CD4(+) T细胞计数增加较小的危险因素。结论。接受非加强型 PI-、NNRTI- 和加强型 PI 基础 cART 的患者的 CD4(+) T 细胞恢复情况相似。
Background. In recent years, treatment options for human immunodeficiency virus type 1 (HIV-1) infection have changed from nonboosted protease inhibitors (PIs) to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) and boosted PI-based antiretroviral drug regimens, but the impact on immunological recovery remains uncertain.Methods. During January 1996 through May 2007, all patients in the Swiss HIV Cohort were included if they received the first combination antiretroviral therapy (cART) and had known baseline CD4(+) T cell counts and HIV1 RNA values (n=3293). The mean (+/- SD) duration of follow-up was months. The follow-up time was limited to the duration of the first cART. CD4(+) T cell recovery was analyzed in 3 different treatment groups: nonboosted PI, NNRTI, or boosted PI. The end point was the absolute increase of CD4(+) T cell count in the 3 treatment groups after the initiation of cART.Results. Two thousand five hundred ninety individuals (78.7%) initiated a nonboosted-PI regimen, 452 ( 13.7%) initiated an NNRTI regimen, and 251 (7.6%) initiated a boosted-PI regimen. Absolute CD4(+) T cell count increases at 48 months were as follows: in the nonboosted-PI group, from 210 to 520 cells/mL; in the NNRTI group, from 220 to 475 cells/mL; and in the boosted-PI group, from 168 to 511 cells/mL. In a multivariate analysis, the treatment group did not affect the response of CD4(+) T cells; however, increased age, pretreatment with nucleoside reverse-transcriptase inhibitors, serological tests positive for hepatitis C virus, Centers for Disease Control and Prevention stage C infection, lower baseline CD4(+) T cell count, and lower baseline HIV-1 RNA level were risk factors for smaller increases in CD4(+) T cell count.Conclusion. CD4(+) T cell recovery was similar in patients receiving nonboosted PI-, NNRTI-, and boosted PI based cART.