摘要目的 观察并比较≥18岁HIV感染者(感染者)接受国家免费艾滋病抗病毒治疗(ART) 36个月内,不同年龄组CD4+T淋巴细胞(CD4)计数水平,探讨年龄因素对参加ART的感染者CD4计数水平的影响.方法 研究对象为2010年1月1日至2012年12月31日在广州市、柳州市和昆明市3家艾滋病治疗定点医院初次接受ART年龄≥18岁感染者,观察时间为初次接受ART之日(基线)起满36个月.研究对象基线和随访数据通过国家ART信息系统收集.按照基线年龄分组为18 ～ 49岁组、50～ 59岁组和≥60岁组.CD4计数按照基线水平分为＜200个/μl和200～ 350个/μl两层.以基线和治疗36个月内不同时间CD4计数水平为因变量,应用混合效应线性模型分析基线年龄、病毒抑制情况、性别、基线CD4/CD8比值以及开始ART方案等因素对CD4计数水平的影响.结果 共收集5 331例感染者数据.基线CD4＜200个/μl和200 ～350个/μ1两层的年龄构成差异无统计学意义(x2=0.13,P=0.938).在基线CD4＜200个/μl层,50 ～59岁组和≥60岁组在ART 36个月内的CD4计数水平均低于18 ～ 49岁组;在基线CD4为200 ～350个/μl层,50～59岁组与18～ 49岁组的CD4计数水平差异无统计学意义,≥60岁组的CD4计数水平低于18 ～ 49岁组.结论 年龄是ART后CD4计数水平的相关影响因素,针对≥50岁感染者应该更早启动ART,有助于其免疫功能恢复.

abstractsObjective To compare the differences of CD4 +T lymphocyte (CD4) counts between patients aged 18 and over,to explore the effect of age on treatment,36 months after having received the China National Free AIDS Antiretroviral Treatment on HIV/AIDS.Methods Through the National ART Information Ssystem,we selected those HIV/AIDS patients who initiated the ART 36 months after the ART,between January 1,2010 and December 31,2012 in Guangzhou,Liuzhou and Kunming.Patients were divided into age groups as 18-49,50-59 and 60 or over year olds,at the baseline of treatment.Under different levels of baseline CD4 counts,we chose the baseline and different time-point of CD4 counts as dependent variables,applied mixed linear model to analyze the effects of age,viral suppression,gender,baseline CD4/CDs ratio and initial treatment regimen.Results A total of 5 331 HIV/AIDS patients were recruited.No differences were found on age group ratios between different levels of baseline CD4 counts.At the level of baseline CD4＜200 cells/μl,both the 50-59 and 60 or above years old groups had lower CD4 counts than the 18-49 year-old group,within 36 months after the initiation of ART.However,at the baseline CD4 level of 200-350 cells/μl,no signiftcant differences on CD4 counts between the 50-59 year-old and 18-49 year-old groups were noticed.CD4 counts seemed lower in the 60 and above year-old group than in the 18-49 year-old group.Conclusion Age might serve as an influencing factor on CD4 counts within 36 months after the initiation of ART,suggesting that earlier initiation of ART might be of help to the recovery of immune function in the 50-59 year-old group.