Association Between CD4/CD8 Ratio Recovery and Chronic Kidney Disease Among Human Immunodeficiency Virus-Infected Patients Receiving Antiretroviral Therapy: A 17-Year Observational Cohort Study.
Association Between CD4/CD8 Ratio Recovery and Chronic Kidney Disease Among Human Immunodeficiency Virus-Infected Patients Receiving Antiretroviral Therapy: A 17-Year Observational Cohort Study.
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接受抗逆转录病毒治疗的人类免疫缺陷病毒感染患者的 CD4/CD8 比率恢复与慢性肾脏病之间的关联：一项为期 17 年的观察性队列研究
DOI：
10.3389/fmicb.2022.827689
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发表时间：
2022
影响因子：
5.2
通讯作者：
Jiang J
中科院分区：
文献类型：
--
作者：
Qin F;Lv Q;Hong W;Wei D;Huang K;Lan K;Chen R;Liu J;Liang B;Liang H;Liang H;Qin S;Ye L;Jiang J
CD 4/CD 8比值被认为是人类免疫缺陷病毒（HIV）相关疾病的新兴生物标志物。然而，CD 4/CD 8比值恢复与慢性肾脏病（CKD）的关系，以及累积抗逆转录病毒治疗（ART）是否能有效恢复CD 4/CD 8比值和降低HIV患者的CKD发病率仍不清楚。在中国广西对所有接受ART的HIV感染患者进行了一项为期17年的观察性队列研究。采用Kaplan-Meier分析研究累积CKD发生率。采用考克斯回归分析和倾向评分匹配（PSM）评价CD 4/CD 8比值恢复与CKD发病率的关系，以及ART方案对CD 4/CD 8比值恢复和CKD发病率的影响。共有59，268名合格个体参与了285，143人-年的随访，总体CKD发病率为9.65%。ART后，CKD患者的死亡率高于肾功能正常的患者（12.48% vs.7.57%，p < 0.001）。CD 4/CD 8比值未恢复至0.7的患者的CKD发生率高于恢复的患者（aHR = 2.84，95% CI 2.63-3.07），与PSM分析相似（aHR = 3.13，95% CI 2.85-3.45）。与PI方案和INSTI方案相比，NNRTI方案的CD 4/CD 8比值恢复率更好（分别为27.04、16.16和29.66%），CKD发生率更低（分别为17.43、16.16和7.31%）。这种大规模的真实世界环境提供了新的证据，表明接受ART的HIV感染患者的CD 4/CD 8比值恢复与较低的CKD发生率相关。基于NNRTI的治疗是CD 4/CD 8比值恢复和降低CKD风险的更好选择。
CD4/CD8 ratio is considered as an emerging biomarker for human immunodeficiency virus (HIV)-related diseases. However, the relationship of CD4/CD8 ratio recovery and chronic kidney disease (CKD), and whether cumulative antiretroviral therapy (ART) is effective in the CD4/CD8 ratio recovery and in reducing CKD incidence among HIV patients remain unclear. A 17-year observational cohort study was conducted on all HIV-infected patients receiving ART in Guangxi, China. Kaplan–Meier analysis was used to investigate the cumulative CKD incidence. Cox regression and propensity score matching (PSM) were used to evaluate the association between CD4/CD8 ratio recovery and CKD incidence, and the effect of ART regimens on CD4/CD8 ratio recovery and CKD incidence. A total of 59,268 eligible individuals contributing 285,143 person-years of follow-up, with an overall CKD incidence of 9.65%. After ART, patients who developed CKD showed higher mortality than those with normal kidney function (12.48 vs. 7.57%, p < 0.001). Patients whose CD4/CD8 ratio did not recover to 0.7 had a higher CKD incidence than the patients who recovered (aHR = 2.84, 95% CI 2.63–3.07), similar to the PSM analysis (aHR = 3.13, 95% CI 2.85–3.45). Compared with the PI-based and INSTI-based regimens, NNRTI-based regimen had a better CD4/CD8 ratio recovery rate (27.04, 16.16, and 29.66%, respectively) and a lower CKD incidence (17.43, 16.16, and 7.31%, respectively). This large-scale real-world setting provide new evidence that the CD4/CD8 ratio recovery is associated with lower CKD incidence in HIV-infected patients receiving ART. NNRTI-based is a better choice for CD4/CD8 ratio recovery and reducing the risk of CKD.
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影响因子：
2.9
作者：
Lee SS;Wong NS;Wong BCK;Wong KH;Chan KCW
通讯作者：
Chan KCW
影响因子：
6.4
作者：
Kooij, Katherine W.;Vogt, Liffert;Reiss, Peter
通讯作者：
Reiss, Peter
DOI：
10.1093/cid/cix466
发表时间：
2017-09-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Trickey A;May MT;Schommers P;Tate J;Ingle SM;Guest JL;Gill MJ;Zangerle R;Saag M;Reiss P;Monforte AD;Johnson M;Lima VD;Sterling TR;Cavassini M;Wittkop L;Costagliola D;Sterne JAC;Antiretroviral Therapy Cohort Collaboration (ART-CC)
通讯作者：
Antiretroviral Therapy Cohort Collaboration (ART-CC)
影响因子：
3.7
作者：
Ekrikpo UE;Kengne AP;Bello AK;Effa EE;Noubiap JJ;Salako BL;Rayner BL;Remuzzi G;Okpechi IG
通讯作者：
Okpechi IG
影响因子：
16.1
作者：
Mocroft, Amanda;Lundgren, Jens D.;Ryom, Lene
通讯作者：
Ryom, Lene