{"title":"高活性抗逆转录病毒治疗开始后,病毒学抑制但CD4+ t细胞计数≤200细胞/mm3的hiv感染患者的患病率:一项荟萃分析","authors":"Zhihui Wu, Chunling Yang, Yuqing Ma, Yueyuan Wang, Zhenkui Zhang, Zhibin Liu, Pengyu Li, Huijun Guo, Yantao Jin","doi":"10.24875/AIDSRev.21000011","DOIUrl":null,"url":null,"abstract":"<p><p>Highly active antiretroviral therapy (HAART) strongly inhibits HIV replication. However, many patients show suboptimal immune recovery (SIR), as defined by virological suppression (i.e. low viral load) with a CD4<sup>+</sup> T-cell count of ≤ 200 cells/mm<sup>3</sup>, after HAART initiation. Here, we performed a systematic evaluation of the SIR prevalence among HIV-infected patients in cohort studies. We searched PubMed, Cochrane Library, Embase, CNKI, Wanfang database, and Chinese Biomedicine Database for cohort studies about HIV-infected participants whose CD4<sup>+</sup> T-cell count was ≤ 200 cells/mm<sup>3</sup> but still had virological suppression after HAART initiation. The SIR prevalence from each of those cohort studies was pooled into a random-effect meta-analysis. We obtained two kinds of pooled post-HARRT initiation SIR prevalence: one among participants with virological suppression (11 cohort studies involving 18,672 participants), and the other among all HIV-infected participants (seven cohort studies involving 12,063 participants). The pooled SIR prevalence among HIV-infected patients with virological suppression after HAART initiation was 43% (95% confidence interval [CI], 34-51%) at 6 months post-HAART initiation and 10% (95% CI, 5-18%) at 36 months post-HAART initiation; among all HIV-infected patients after HAART initiation, it was 17% (95% CI, 0-55%) and 5% (95% CI, 2-10%) at 6 and 36 months post-HAART initiation, respectively. The SIR prevalence among HIV-infected patients is high at 6 months post-HAART initiation, but its prevalence gradually reduces over time under continuous HAART. Thus, it is important to follow-up on variations in the CD4<sup>+</sup> T-cell count and viral load.</p>","PeriodicalId":7685,"journal":{"name":"AIDS reviews","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"The Prevalence of HIV-infected Patients with Virological Suppression but a CD4<sup>+</sup> T-cell Count of ≤ 200 Cells/mm<sup>3</sup> after Highly Active Antiretroviral Therapy Initiation: A Meta-analysis.\",\"authors\":\"Zhihui Wu, Chunling Yang, Yuqing Ma, Yueyuan Wang, Zhenkui Zhang, Zhibin Liu, Pengyu Li, Huijun Guo, Yantao Jin\",\"doi\":\"10.24875/AIDSRev.21000011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Highly active antiretroviral therapy (HAART) strongly inhibits HIV replication. However, many patients show suboptimal immune recovery (SIR), as defined by virological suppression (i.e. low viral load) with a CD4<sup>+</sup> T-cell count of ≤ 200 cells/mm<sup>3</sup>, after HAART initiation. Here, we performed a systematic evaluation of the SIR prevalence among HIV-infected patients in cohort studies. We searched PubMed, Cochrane Library, Embase, CNKI, Wanfang database, and Chinese Biomedicine Database for cohort studies about HIV-infected participants whose CD4<sup>+</sup> T-cell count was ≤ 200 cells/mm<sup>3</sup> but still had virological suppression after HAART initiation. The SIR prevalence from each of those cohort studies was pooled into a random-effect meta-analysis. We obtained two kinds of pooled post-HARRT initiation SIR prevalence: one among participants with virological suppression (11 cohort studies involving 18,672 participants), and the other among all HIV-infected participants (seven cohort studies involving 12,063 participants). The pooled SIR prevalence among HIV-infected patients with virological suppression after HAART initiation was 43% (95% confidence interval [CI], 34-51%) at 6 months post-HAART initiation and 10% (95% CI, 5-18%) at 36 months post-HAART initiation; among all HIV-infected patients after HAART initiation, it was 17% (95% CI, 0-55%) and 5% (95% CI, 2-10%) at 6 and 36 months post-HAART initiation, respectively. The SIR prevalence among HIV-infected patients is high at 6 months post-HAART initiation, but its prevalence gradually reduces over time under continuous HAART. Thus, it is important to follow-up on variations in the CD4<sup>+</sup> T-cell count and viral load.</p>\",\"PeriodicalId\":7685,\"journal\":{\"name\":\"AIDS reviews\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.24875/AIDSRev.21000011\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.24875/AIDSRev.21000011","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
The Prevalence of HIV-infected Patients with Virological Suppression but a CD4+ T-cell Count of ≤ 200 Cells/mm3 after Highly Active Antiretroviral Therapy Initiation: A Meta-analysis.
Highly active antiretroviral therapy (HAART) strongly inhibits HIV replication. However, many patients show suboptimal immune recovery (SIR), as defined by virological suppression (i.e. low viral load) with a CD4+ T-cell count of ≤ 200 cells/mm3, after HAART initiation. Here, we performed a systematic evaluation of the SIR prevalence among HIV-infected patients in cohort studies. We searched PubMed, Cochrane Library, Embase, CNKI, Wanfang database, and Chinese Biomedicine Database for cohort studies about HIV-infected participants whose CD4+ T-cell count was ≤ 200 cells/mm3 but still had virological suppression after HAART initiation. The SIR prevalence from each of those cohort studies was pooled into a random-effect meta-analysis. We obtained two kinds of pooled post-HARRT initiation SIR prevalence: one among participants with virological suppression (11 cohort studies involving 18,672 participants), and the other among all HIV-infected participants (seven cohort studies involving 12,063 participants). The pooled SIR prevalence among HIV-infected patients with virological suppression after HAART initiation was 43% (95% confidence interval [CI], 34-51%) at 6 months post-HAART initiation and 10% (95% CI, 5-18%) at 36 months post-HAART initiation; among all HIV-infected patients after HAART initiation, it was 17% (95% CI, 0-55%) and 5% (95% CI, 2-10%) at 6 and 36 months post-HAART initiation, respectively. The SIR prevalence among HIV-infected patients is high at 6 months post-HAART initiation, but its prevalence gradually reduces over time under continuous HAART. Thus, it is important to follow-up on variations in the CD4+ T-cell count and viral load.
期刊介绍:
AIDS Reviews publishes papers reporting original scientific, clinical, epidemiologic and social research which contribute to the overall knowledge of the field of the acquired immunodeficiency syndrome and human retrovirology. Currently, the Journal publishes review articles (usually by invitation, but spontaneous submitted articles will also be considered). Manuscripts submitted to AIDS Reviews will be accepted on the understanding that the authors have not submitted the paper to another journal or published the material elsewhere.