Clinical, Biologic, and Behavioral Predictors of Early Immunologic and Virologic Response in HIV‐Infected Patients Initiating Protease Inhibitors
Clinical, Biologic, and Behavioral Predictors of Early Immunologic and Virologic Response in HIV‐Infected Patients Initiating Protease Inhibitors
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启动蛋白酶抑制剂的 HIV 感染患者早期免疫学和病毒学反应的临床、生物学和行为预测因素
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
C. Leport
中科院分区：
文献类型：
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作者：
V. Moing;G. Chêne;Maria Patrizia Carrieri;J. Besnier;B. Masquelier;R. Salamon;C. Bazin;J. Moatti;F. Raffi;C. Leport
总结：在开始含蛋白酶抑制剂（PI）方案时前瞻性入组的750例HIV-1感染患者中，研究了治疗4个月（M4）后病毒学（血浆HIV RNA病毒载量[VL] <500拷贝/ml）和免疫学（CD 4+细胞计数升高>50个细胞/mm 3）应答的预测因素。在80%的患者中观察到病毒学应答，在64%的患者中观察到免疫学应答。62%的患者在治疗1个月（M1）和M4时自我报告完全依从治疗。在多变量分析中，病毒学应答在完全依从的患者中更常见（比值比[OR] = 2.0; p = 0.001）。免疫应答与年龄<36岁相关（OR = 1.4; p = .03），基线VL（OR = 1.5/1 log 10拷贝/ml升高; p < .01），M1时VL降低（OR = 1.5/1 log 10拷贝/ml降低; p < .01），基线总淋巴细胞计数（OR = 1.7/50%降低; p <0.001）和基线CD 4+细胞百分比≥ 20%（OR = 1.9; p <0.001），但不依从治疗。完全依从性似乎是含P1三联疗法病毒学应答的主要预测因素。免疫应答可能是可能的，尽管不完全遵守，至少在治疗早期。
Summary: Predictors of virologic (plasma HIV RNA viral load [VL] <500 copies/ml) and immunologic (rise in CD4+ cell count >50 cells/mm3) response after 4 months of therapy (M4) were studied in 750 HIV‐1‐infected patients prospectively enrolled at the initiation of a protease inhibitor (PI)‐containing regimen. A virologic response was observed in 80% of patients, and an immunologic response was observed in 64%. Sixty‐two percent of patients self‐reported full adherence to therapy at 1 month of therapy (M1) and M4. In multivariate analysis, a virologic response was more frequent in fully adherent patients (odds ratio [OR] = 2.0; p = .001). An immunologic response was associated with age <36 years (OR = 1.4; p = .03), baseline VL (OR = 1.5 per 1 log10 copies/ml higher; p < .01), decrease in VL at M1 (OR = 1.5 per 1 log10 copies/ml decrease; p < .01), baseline total lymphocyte count (OR = 1.7 per 50% lower; p < .001), and baseline CD4+ cell percentage ≥ 20% (OR = 1.9; p < .001) but not with adherence to therapy. Full adherence seems to be a major predictor of a virologic response to P1‐containing triple therapy. An immunologic response may be possible despite incomplete adherence, at least early in therapy.