Abstract：Objective To study the factors affecting disease progression of sexually-transmitted HIV/AIDS patients in Shenzhen city. Methods We studied the general situation and distribution of HLA-B genotypes in 280 sexually-transmitted HIV/AIDS patients in Shenzhen city, and analyzed their associations with the disease progression. Results Two hundred and eighty sexually-transmitted HIV/AIDS patients were divided into the typical progressor (TP) group (79.64%, n=223) and the slow progressor (SP) group(20.36%, n=57). Single factor analysis showed that the constituent ratios of gender, household registration, education level, marital status, route of transmission, baseline CD4 level and HLA-B genotype were statistically significant different between the TP group and the SP group (all P<0.05). The constituent ratio of HLA-BW4/BW4 homozygote was relatively lower in the TP group than in the SP group (10.31% vs. 22.81%), while the constituent ratio of HLA-BW6/BW6 homozygote was relatively higher in the TP group than in the SP group (43.05% vs. 29.82%). Multiple logistic regression analysis indicated that sex(OR=0.030, 95%CI=0.003-0.278), education level(OR=0.066,95%CI=0.014-0.316),transmission route(OR=0.222,95%CI=0.049-0.994),baseline CD4(OR=0.002,95%CI=0.000-0.012), and HLA-B genotype (OR=35.845, 95%CI=3.309-388.274) were the factors affecting the disease progression (all P<0.05). Female, higher education level, heterosexual transmission, baseline CD4 > 500 cells/μl and HLA-BW4/BW4 genotypes were protective factors for delaying the disease progression. Conclusions Gender, education level, transmission route, baseline CD4 and HLA-B genotypes are the factors influencing the disease progression of sexually-transmitted HIV/AIDS.
[1] 孔衍琳. 我国艾滋病流行近况分析[J]. 热带医学杂志,2014,14(12):1657-1660. [2] Wu JQ, Wang B, Belov L, et al. Antibody microarray analysis of cell surface antigens on CD4+ and CD8+T cells from HIV+ individuals correlates with disease stages[J]. Retrovirology, 2007,26(4):83-88. [3] Jiang Y, Chen O, Cui C, et al. KIR3DS1/L1 and HLA-Bw4-80I are associated with HIV disease progression among HIV typical progressors and long-term nonprogressors [J]. BMC Infect Dis, 2013, 2(13): 405-410. [4] Dorrucci M,Rezza G,Porter K,et al. TemPoral trends in postseroconversion CD4 cell count and HIV load: the concerted action on seroconversion to AIDS and death in Europe collaboration,1985-2002[J]. J Infect Dis,2007,195(4):525-534. [5]Sterne JA, May M, Costagliola D, et al. Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies [J]. Lancet, 2009,373(9672):1352-1363. [6] Yan H, Yang H, Li J, et al. Emerging disparity in HIV/AIDS disease progression and mortality for men who have sex with men, Jiangsu Province, China[J]. AIDS Behav, 2014,18 (Suppl):s5-10. [7] 谢年华,江洪波,许骏,等.武汉市HIV/AIDS未治疗患者生存质量及影响因素研究[J].中华疾病控制杂志,2015,19(12):1204-1207,1219. [8] Nsanzimana S, Remera E, Kanters S, et al. Effect of baseline CD4 cell count at linkage to HIV care and at initiation of antiretroviral therapy on mortality in HIV-positive adult patients in Rwanda: a nationwide cohort study[J]. Lancet HIV, 2015, 2(9): e376-384. [9] 郑武,笪琴,汤恒,等.湖北省2003－2015年艾滋病抗病毒治疗死亡病例流行病学分析[J].中国热带医学,2017,17(10):1002-1004. [10] 李燕,徐慧芳,韩志刚,等.CD4T淋巴细胞增殖与艾滋病疾病进展的关系研究[J].中国艾滋病性病,2013,19(2):91-95. [11] Dyer WB, Zaunders JJ, Yuan FF, et al. Mechanisms of HIV non-progression; robust and sustained CD4 -cell proliferative responses to p24 antigen correlate with control of viraemia and lack of disease progression after long-term transfusion-acquired HIV-1 infection[J]. Retrovirology, 2008,11(5):112-117. [12] 阿迪拉·苏力旦,热依拜·亚地佧尔,地力夏提·亚克甫.新疆伊宁市2006－2015年HIV/AIDS患者生存状况分析[J].实用预防医学,2017,24(2):181-184. [13] Dinges WL, Richardt J, Friedrich D, et al. Virus-specific CD8+ T-cell responses better define HIV disease progression than HLA genotype [J]. J Virol, 2010,84(9):4461-4468. [14] Li WH, Li CY, Yang HB, et al. Human leucocyte antigen-Bw4 and Gag-specific T cell responses are associated with slow disease progression in HIV-1B-infected anti-retroviral therapy-naive Chinese[J].Clin Exp Immunol, 2013, 171(3):298-306.
2019, Vol. 26 
