Hormonal contraceptive use and the effectiveness of highly active antiretroviral therapy
Hormonal contraceptive use and the effectiveness of highly active antiretroviral therapy
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DOI：
10.1093/aje/kwi116
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发表时间：
2005-05-01
影响因子：
5
通讯作者：
Greenblatt, RM
中科院分区：
文献类型：
--
作者：
Chu, JH;Gange, SJ;Greenblatt, RM
在女性机构间 HIV 研究的参与者中，对激素避孕药的使用在高效抗逆转录病毒治疗 (HAART) 有效性中的作用进行了检查，这些参与者从 HAART 开始到 2001 年进行了跟踪。使用倾向评分选择将 77 名激素避孕药使用者与 77 名非使用者在年龄、种族和 HAART 前 CD4 阳性 T 淋巴细胞 (CD4+ 细胞) 计数和病毒载量方面进行匹配。作者比较了激素避孕药使用者和非使用者在开始 HAART 后的 CD4+ 细胞计数和病毒载量反应。比例风险分析用于评估激素避孕药的使用对 CD4+ 细胞计数增加至 50 个细胞/mm(3) 和 100 个细胞/mm(3) 的时间以及达到不可检测的病毒载量的影响。除了开始后第三次就诊时的对数病毒载量外，HAART 开始后激素使用导致的 CD4+ 细胞计数和对数病毒载量反应没有统计学上的显着差异（p = 0.047）。时间依赖性激素避孕药的使用并不是在开始 HAART 后实现 CD4+ 细胞计数增加 50 个细胞/mm(3) 和 100 个细胞/mm(3) 或检测不到病毒载量（分别为 p = 0.517、p = 0.751 和 p = 0.218）的统计显着预测因素。总之，作者没有发现实质性证据表明激素避孕药的使用会强烈影响 HAART 的反应。
The role of hormonal contraceptive use in the effectiveness of highly active antiretroviral therapy (HAART) was examined among participants in the Women's Interagency HIV Study who were followed from HAART initiation to 2001. Propensity score selection was used to match 77 hormonal contraceptive users with 77 nonusers on age, race, and pre-HAART CD4-positive T-lymphocyte (CD4+ cell) count and viral load. The authors compared hormonal contraceptive users and nonusers with regard to the CD4+ cell count and viral load responses to HAART upon initiation. Proportional hazards analyses were used to assess the effect of hormonal contraceptive use on times to increases in CD4+ cell count of 50 cells/mm(3) and 100 cells/mm(3) and achievement of an undetectable viral load. There were no statistically significant differences in CD4+ cell counts and log viral load responses by hormone use after HAART initiation, except in log viral load at the third visit after initiation (p = 0.047). Time-dependent hormonal contraceptive use was not a statistically significant predictor of achieving increases in CD4+ cell count of 50 cells/mm(3) and 100 cells/mm(3) or an undetectable viral load (p = 0.517, p = 0.751, and p = 0.218, respectively) after HAART initiation. In conclusion, the authors did not find substantial evidence that use of hormonal contraceptives strongly affected responses to HAART.