Prevalence of and prognosis for poor immunological recovery by virally suppressed and aged HIV-infected patients

Autor: Lina Fan, Penghui Li, Aiping Yu, Dan Liu, Ziyu Wang, Yue Wu, Defa Zhang, Meiyin Zou, Ping Ma
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Medicine, Vol 10 (2023)
Druh dokumentu: article
ISSN: 2296-858X
DOI: 10.3389/fmed.2023.1259871
Popis: BackgroundAntiretroviral therapy (ART) prolongs lifespan and decreases mortality of HIV infected patients. However, many patients do not achieve optimal immune reconstitution. The influence of non-optimal immune recovery on non-AIDS related diseases is not well defined in aged HIV-infected patients receiving ART.MethodsA retrospective study was conducted at Tianjin Second People’s Hospital, China to evaluate the association of an inadequate immunological response and non-AIDS diseases in HIV infected patients ≥60 years of age and virally suppressed for at least 2 years by ART.ResultsThe study included patients (n = 666) who initiated ART between August 2009 and December 2020. The prevalence of patients with an inadequate immunological response was 29.6%. The percentage of non-AIDS diseases such as hypertension, cardiovascular disease (CVD), diabetes, tumor, and chronic kidney disease (CKD) was 32.9, 9.9, 31, 4.1, and 13%, respectively. In addition to baseline CD4+ T cell counts, CVD and tumor were associated with poor immune reconstitution in aged Chinese HIV-1 infected patients. The adjusted odds ratios (95% confidence interval) were AOR 2.45 (95% CI: 1.22–4.93) and 3.06 (95% CI: 1.09–8.56, p = 0.03). Inadequate immunological response was associated with greater mortality (AOR: 2.83, 95% CI: 1.42–5.67, p = 0.003) in this cohort.ConclusionThese results tend to demonstrate appropriate drug selection at ART initiation and prevention of non-AIDS complications during ART decreased mortality of and an inadequate immunological response in aged HIV infected patients.
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