Relationship Between a Frailty-Related Phenotype and Progressive Deterioration of the Immune System in HIV-Infected Men
Relationship Between a Frailty-Related Phenotype and Progressive Deterioration of the Immune System in HIV-Infected Men
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DOI：
10.1097/qai.0b013e3181945eb0
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发表时间：
2009-03-01
影响因子：
3.6
通讯作者：
Jacobson, Lisa P.
中科院分区：
文献类型：
--
作者：
Desquilbet, Loic;Margolick, Joseph B.;Jacobson, Lisa P.
背景：已注意到艾滋病毒感染者和艾滋病毒阴性老年人之间的免疫学相似性。随着年龄的增长，免疫学的改变已引起老年人的虚弱，这是一种死亡和其他不良后果高风险的临床综合征。使用虚弱相关表型 (FRP)，我们在多中心艾滋病队列研究中调查了 HIV 阳性个体中免疫系统的进行性恶化是否独立预测 FRP 的发生。方法：从 1994 年到 2005 年，每半年对 1046 名 HIV 感染男性进行 FRP 评估。 回归。 （广义估计方程），调整年龄、种族、教育水平、艾滋病状况和治疗时代[前高效抗逆转录病毒治疗 (HAART) (1994-1995) 和 HAART (1996-1999 和 2000-2005)]。结果：调整后的 FRP 患病率在 CD4 T 细胞计数 > 400 个细胞/立方毫米时仍然较低，并呈指数级显着增加对于较低的 很重要。结果不受治疗时代的影响。 1996 年之后，CD4 T 细胞计数（而非血浆病毒载量）与 FRP 独立相关。结论：CD4 T 细胞计数可预测 HIV 感染男性中 FRP 的发生，与 HAART 的使用无关。这表明，HIV 感染者的免疫系统受损会导致身体虚弱的全身生理功能障碍。
Context: Immunological similarities have been noted between HIV-infected individuals and older HIV-negative adults. immunologic alterations with aging have been noted in frailty in older adults, a clinical syndrome of high risk for mortality and other adverse outcomes. Using a frailty-related phenotype (FRP), we investigated in the Multicenter AIDS Cohort Study whether progressive deterioration of the immune system among HIV-positive individuals independently predicts onset of FRP.Methods: FRP was evaluated semiannually in 1046 HIV-infected men from 1994 to 2005. CD4 T-cell Count and plasma viral load were evaluated as predictors of FRP by logistic regression. (generalized estimating equations), adjusting for age, ethnicity, educational level, AIDS status, and treatment era [pre-highly active antiretroviral therapy (HAART) (1994-1995) and HAART (1996-1999 and 2000-2005)].Results: Adjusted prevalences of FRP remained low for CD4 T-cell counts > 400 cells per cubic millimeter and increased exponentially and significantly for lower counts. Results were unaffected by treatment era. After 1996, CD4 T-cell count, but not plasma viral load, was independently associated with FRP.Conclusions: CD4 T-cell count predicted the development of a FRP among HIV-infected men, independent of HAART use. This suggests that compromise of the immune system in HTV-infected individuals contributes to the systemic physiologic dysfunction of frailty.