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. 2023 Oct 19:10:1259871.
doi: 10.3389/fmed.2023.1259871. eCollection 2023.

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

Lina Fan  1 , Penghui Li  2 , Aiping Yu  1 , Dan Liu  1 , Ziyu Wang  1 , Yue Wu  1   3 , Defa Zhang  1   3 , Meiyin Zou  4 , Ping Ma  1   5
Affiliations

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

Lina Fan et al. Front Med (Lausanne). .

Abstract

Background: Antiretroviral 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.

Methods: A 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.

Results: The 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.

Conclusion: These 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.

Keywords: HIV/AIDS; cardiovascular disease; inadequate immunological responders; non-AIDS related; tumor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Flow chart showing patient characteristics and selection; (B) the percentage of non-AIDS diseases.
Figure 2
Figure 2
(A) Death of immune non-responders and immune responders; (B) mortality curves of HIV infected patients with or without CVD; (C) mortality curves of HIV infected patients with or without tumor; (D) mortality curves of HIV infected patients with or without immune recovery.
See this image and copyright information in PMC

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