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目的分析男男性行为(MSM)人群艾滋病病毒感染者和艾滋病患者(HIV/AIDS)基线CD4+T淋巴细胞(CD4)水平对艾滋病抗病毒治疗效果的影响。方法于2014年7月1日—2016年6月30日招募杭州市MSM人群初次接受艾滋病抗病毒治疗的HIV/AIDS,将基线CD4≥500/μL定为观察组,<500/μL定为对照组,定期随访并检测CD4和病毒载量,比较两组HIV/AIDS抗病毒治疗效果。结果共纳入HIV/AIDS 1 206例,其中对照组1 026例,观察组180例。观察组和对照组在治疗随访第12个月时,CD4恢复到719/μL(浙江省正常成人CD4中位数)的比例分别为39.13%和12.50%;第18个月时分别为38.71%和13.75%。观察组CD4首次恢复成功所需的中位时间为7.2个月,少于对照组的20.4个月(P<0.05)。治疗满12个月时,对375例HIV/AIDS进行病毒载量检测,病毒抑制成功(<400 copies/m L)365例,占97.33%。观察组和对照组的病毒抑制成功率分别为96.34%和97.50%,差异无统计学意义(P>0.05)。结论基线CD4≥500/μL和<500/μL的MSM人群HIV/AIDS抗病毒治疗病毒抑制成功率相近,前者CD4首次恢复用时较短。
Objective To analyze the influence of baseline CD4 + T lymphocyte (CD4) levels in HIV-positive and HIV-positive patients on HIV / AIDS in men who have sex with men (MSM). Methods From July 1, 2014 to June 30, 2016, HIV / AIDS patients receiving MSM in Hangzhou for the first time were enrolled in this study. The baseline CD4≥500 / μL was defined as the observation group, and the value of <500 / μL was defined as the control Group, regular follow-up and detection of CD4 and viral load, the two groups of HIV / AIDS antiviral treatment effect. Results A total of 1 206 HIV / AIDS cases were included, of which 1 026 in the control group and 180 in the observation group. In the observation group and the control group, the proportion of CD4 recovering to 719 / μL (median of normal adults in Zhejiang Province) was 39.13% and 12.50% respectively at the 12th month of follow-up and 38.71% at 18th month 13.75%. The median time required for the first recovery of CD4 in the observation group was 7.2 months, less than 20.4 months in the control group (P <0.05). After 12 months of treatment, 375 cases of HIV / AIDS were tested for viral load, and 365 cases (97.33%) had successful virus suppression (<400 copies / m L). The success rates of virus suppression in the observation group and the control group were 96.34% and 97.50%, respectively, with no significant difference (P> 0.05). Conclusions The success rates of HIV / AIDS antiviral treatment of virus in MSM population with baseline CD4≥500 / μL and <500 / μL are similar, with the former being shorter for the first time.