The effect of HAART on HIV RNA trajectory among treatment-naïve men and women: a segmental Bernoulli/lognormal random effects model with left censoring.
The effect of HAART on HIV RNA trajectory among treatment-naïve men and women: a segmental Bernoulli/lognormal random effects model with left censoring.
复制标题
DOI：
10.1097/ede.0b013e3181ce9950
复制
发表时间：
2010-07
期刊：
影响因子：
--
通讯作者：
Jacobson LP
中科院分区：
文献类型：
--
作者：
Chu H;Gange SJ;Li X;Hoover DR;Liu C;Chmiel JS;Jacobson LP
高效抗逆转录病毒疗法（HAART）可迅速抑制人类免疫缺陷病毒（HIV）的病毒复制并降低循环病毒载量，但HAART对病毒载量的长期影响尚不清楚。我们在多中心艾滋病队列研究和妇女机构间艾滋病研究中评估了HAART启动后8年内的艾滋病病毒载量轨迹。该研究包括157名HIV感染的男性和199名HIV感染的女性，他们是抗逆转录病毒初治者，分别在HAART后提供了1311和1837名半年一次的就诊者。为了解释受试者内相关性和左删失病毒载量的高比例，我们使用了分段伯努利/对数正态随机效应模型。约3个月HAART开始后（男性0.30年，女性0.22年），HIV病毒载量得到最佳抑制（即HIV RNA含量非常低），占44%（95%置信区间= 39%-49%）男性和43%（38%-47%）女性，而另外56%的男性和57%的女性的平均水平分别为2.1（1.5-2.6）和3.0（2.7-3.2）log 10拷贝/mL。HAART治疗8年后，75%的男性和80%的女性获得了最佳抑制，而其余男性和女性的抑制效果不佳，中位HIV RNA分别为3.1和3.7 log 10拷贝/mL。
Highly active antiretroviral therapy (HAART) rapidly suppresses human immunodeficiency virus (HIV) viral replication and reduces circulating viral load, but the long-term effects of HAART on viral load remain unclear. We evaluated HIV viral load trajectories over 8 years following HAART initiation in the Multicenter AIDS Cohort Study and the Women’s Interagency HIV Study. The study included 157 HIV-infected men and 199 HIV-infected women who were antiretroviral naïve and contributed 1311 and 1837 semiannual person-visits post-HAART, respectively. To account for within-subject correlation and the high proportion of left-censored viral loads, we used a segmental Bernoulli/lognormal random effects model. Approximately 3 months (0.30 years for men and 0.22 years for women) after HAART initiation, HIV viral loads were optimally suppressed (ie, with very low HIV RNA) for 44% (95% confidence interval = 39%–49%) of men and 43% (38%–47%) of women, whereas the other 56% of men and 57% of women had on average 2.1 (1.5–2.6) and 3.0 (2.7–3.2) log10 copies/mL, respectively. After 8 years on HAART, 75% of men and 80% of women had optimal suppression, whereas the rest of the men and women had suboptimal suppression with a median HIV RNA of 3.1 and 3.7 log10 copies/mL, respectively.