Pretreatment factors associated with 3-year (144-week) virologic and immunologic responses to potent antiretroviral therapy
Pretreatment factors associated with 3-year (144-week) virologic and immunologic responses to potent antiretroviral therapy
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DOI：
10.1097/qai.0b013e31802c7e20
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发表时间：
2007-03-01
影响因子：
3.6
通讯作者：
Benson, Constance A.
中科院分区：
文献类型：
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作者：
Bosch, Ronald J.;Bennett, Kara;Benson, Constance A.
目的：检查与抗逆转录病毒治疗 (ART) 长期（144 周）反应相关的预处理因素。方法：对 1498 名未接受过 ART 且随机接受 ART 方案（包括 >= 3 种药物）的受试者中的 1083 名患者进行了分析，这些患者在基线和第 144 周时血浆 HIV RNA (vRNA) 水平和 CD4 细胞计数。使用多变量 Cox、对数二项式和线性回归模型评估的主要基线因素是 CD4 细胞计数、vRNA 水平、性别、种族和年龄。结果：达到 vRNA 水平 < 50 拷贝/mL 的时间较短与基线 vRNA 水平较低 (P < 0.001)、年龄较大 (P = 0.007) 和基线 CD4 细胞计数较低 (P = 0.055) 相关。调整种族、性别和基线 CD4 细胞计数后，年龄较大与第 144 周时 vRNA 水平 < 50 拷贝/mL 相关 (P = 0.018)。在年轻男性、黑人和治疗前 vRNA 水平较高的受试者中，CD4 计数从基线到第 144 周有更大的增加（平均值 = 284 个细胞/μL）；治疗前 vRNA 水平的影响在女性中最为明显。结论：年龄较大是第 144 周时 vRNA 水平 < 50 拷贝/mL 的最重要的基线预测因子；较低的治疗前 vRNA 水平和年龄较大是 vRNA 水平 < 50 拷贝/mL 时间的最重要预测因素。预处理因素对 CD4 细胞计数增加的影响在男性和女性之间存在差异。
Objective: To examine pretreatment factors associated with longer term (144 weeks) responses to antiretroviral therapy (ART).Methods: Of 1498 ART-naive subjects randomized to ART regimens, including >= 3 agents, 1083 patients who had plasma HIV RNA (vRNA) levels and CD4 cell counts at baseline and week 144 were analyzed. Primary baseline factors evaluated were CD4 cell count, vRNA level, gender, race, and age, using multivariable Cox, log-binomial, and linear regression models.Results: Shorter time to achieving a vRNA level < 50 copies/mL was associated with lower baseline vRNA level (P < 0.001), older age (P = 0.007), and lower baseline CD4 cell count (P = 0.055). After adjusting for race, gender, and baseline CD4 cell count, older age was associated with a vRNA level < 50 copies/mL at week 144 (P = 0.018). Greater CD4 count increases from baseline to week 144 (mean = 284 cells/mu L) were seen in younger men, blacks, and subjects with higher pretreatment vRNA levels; the effect of pretreatment vRNA level was most apparent in women.Conclusions: Older age was the most important baseline predictor of a vRNA level < 50 copies/mL at week 144; lower pretreatment vRNA level and older age were the most important predictors of time to a vRNA level < 50 copies/mL. The influence of pretreatment factors on increases in CD4 cell counts differed between men and women.