Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study
Abstract Background Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented. Met...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-09021-9 |
| _version_ | 1797275680626442240 |
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| author | Heping Zhao Anping Feng Dan Luo Tanwei Yuan Yi-Fan Lin Xuemei Ling Huolin Zhong Junbin Li Linghua Li Huachun Zou |
| author_facet | Heping Zhao Anping Feng Dan Luo Tanwei Yuan Yi-Fan Lin Xuemei Ling Huolin Zhong Junbin Li Linghua Li Huachun Zou |
| author_sort | Heping Zhao |
| collection | DOAJ |
| description | Abstract Background Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented. Methods We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months’ treatment), immunological incomplete responders (ICRs) (200–350 cells/μl) and INRs (< 200 cells/μl). Multivariable logistic regression was used to assess factors associated with immunological non-response. Results A total of 3900 PLHIV were included, among whom 2309 (59.2%) were IRs, 1206 (30.9%) ICRs and 385 (9.9%) INRs. In multivariable analysis, immunological non-response was associated with being male (2.07, 1.39–3.09), older age [40–49 years (vs. 18–29 years): 2.05, 1.29–3.25; 50–59 years: 4.04, 2.33-7.00; ≥ 60 years: 5.51, 2.84–10.67], HBV co-infection (1.63, 1.14–2.34), HCV co-infection (2.01, 1.01–4.02), lower CD4 + T cell count [50–200 cells/μl (vs. 200–350 cells/μl): 40.20, 16.83–96.01; < 50 cells/μl: 215.67, 85.62-543.26] and lower CD4/CD8 ratio (2.93, 1.98–4.34) at baseline. Compared with patients treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens, those receiving protease inhibitors (PIs) based regimens were less likely to be INRs (0.47, 0.26–0.82). Conclusions We found a sizable immunological non-response rate among HIV-infected patients. Being male, older age, coinfection with HBV and HCV, lower CD4 + T cell count and lower CD4/CD8 ratio are risk factors of immunological non-response, whereas PIs-based regimens is a protective factor. |
| first_indexed | 2024-03-07T15:18:01Z |
| format | Article |
| id | doaj.art-5b033e7e44d14b578e787b8e976c496d |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-07T15:18:01Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-5b033e7e44d14b578e787b8e976c496d2024-03-05T17:49:24ZengBMCBMC Infectious Diseases1471-23342024-01-012411910.1186/s12879-024-09021-9Factors associated with immunological non-response after ART initiation: a retrospective observational cohort studyHeping Zhao0Anping Feng1Dan Luo2Tanwei Yuan3Yi-Fan Lin4Xuemei Ling5Huolin Zhong6Junbin Li7Linghua Li8Huachun Zou9Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical UniversitySchool of Public Health (Shenzhen), Sun Yat-sen UniversitySchool of Public Health (Shenzhen), Sun Yat-sen UniversitySchool of Public Health (Shenzhen), Sun Yat-sen UniversitySchool of Public Health (Shenzhen), Sun Yat-sen UniversityInfectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical UniversityInfectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical UniversityInfectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical UniversityInfectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical UniversitySchool of Public Health, Fudan UniversityAbstract Background Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented. Methods We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months’ treatment), immunological incomplete responders (ICRs) (200–350 cells/μl) and INRs (< 200 cells/μl). Multivariable logistic regression was used to assess factors associated with immunological non-response. Results A total of 3900 PLHIV were included, among whom 2309 (59.2%) were IRs, 1206 (30.9%) ICRs and 385 (9.9%) INRs. In multivariable analysis, immunological non-response was associated with being male (2.07, 1.39–3.09), older age [40–49 years (vs. 18–29 years): 2.05, 1.29–3.25; 50–59 years: 4.04, 2.33-7.00; ≥ 60 years: 5.51, 2.84–10.67], HBV co-infection (1.63, 1.14–2.34), HCV co-infection (2.01, 1.01–4.02), lower CD4 + T cell count [50–200 cells/μl (vs. 200–350 cells/μl): 40.20, 16.83–96.01; < 50 cells/μl: 215.67, 85.62-543.26] and lower CD4/CD8 ratio (2.93, 1.98–4.34) at baseline. Compared with patients treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens, those receiving protease inhibitors (PIs) based regimens were less likely to be INRs (0.47, 0.26–0.82). Conclusions We found a sizable immunological non-response rate among HIV-infected patients. Being male, older age, coinfection with HBV and HCV, lower CD4 + T cell count and lower CD4/CD8 ratio are risk factors of immunological non-response, whereas PIs-based regimens is a protective factor.https://doi.org/10.1186/s12879-024-09021-9PLHIVINRsICRsIRsART |
| spellingShingle | Heping Zhao Anping Feng Dan Luo Tanwei Yuan Yi-Fan Lin Xuemei Ling Huolin Zhong Junbin Li Linghua Li Huachun Zou Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study BMC Infectious Diseases PLHIV INRs ICRs IRs ART |
| title | Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study |
| title_full | Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study |
| title_fullStr | Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study |
| title_full_unstemmed | Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study |
| title_short | Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study |
| title_sort | factors associated with immunological non response after art initiation a retrospective observational cohort study |
| topic | PLHIV INRs ICRs IRs ART |
| url | https://doi.org/10.1186/s12879-024-09021-9 |
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