RESUMEN
Objective Objective To explore the characteristics and determinants of natural chan-ges in CD4+lymphocyte counts among HIV -infected patients without previous antiviral therapy in two dis-tricts of Shanghai . [ Methods] A retrospective study was conducted on HIV -infected patients reported from 1987 through May 2013 in two districts of Shanghai , who had received at least twice CD 4+lymphocyte counting tests before antiretroviral treatment ( ART) .The characteristics of natural changes in CD 4+lympho-cyte count and the determinants of significant decrease in count were described . [ Results] A total of 365 patients were included in the study .The monthly rate of CD 4+lymphocyte count changes between the first and the last counting tests had a median of -4.4 (IQR:-11.1~0.2).Among them 263(72.1%) showed remarkable decrease in CD 4+lymphocyte counts and 143 ( 39 .2%) presented a significant decrease (≥30%).Multiple logistic regression analysis indicated that the age , the first CD4+lymphocyte counts and the interval between the first and the last counting tests were significantly associated with the significant de -crease of CD4+lymphocyte counts among HIV-infected patients. [Conclusion] Natural changes of CD4+lymphocyte counts were gentle as a whole among untreated patients infected with HIV in central districts of Shanghai and rapid decrease in CD 4+lymphocyte counts among some HIV -infected patients was associated with many factors .It is held that CD 4+lymphocyte count and its changing rate should be regularly monitored so as to estimate the progress of the disease and perform targeted behavior intervention and clinic intervention .
RESUMEN
Objective To explore the determinants and changes ofCD4+ T cell counts among antiretroviral treatnent-naive HIV/AIDS patients in Dchong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on HIV-infected local residents, being reported during 1989 through May 2010, in Dehong prefecture. The patients had received at least two CD4 + T cell counting tests before receiving the antiretroviral treatment (ART). Difference between the first and the last CD4 + T cell counts was calculated and described. Logistic regression analysis was conducted to examine the determinants of significant depletion of CD4 + T cell counts among them. Results A total of 4487 HIV/AIDS patients were included in the study. The change of CD4 +T cell counts between the first and the last CD4 + T cell count tests had a median of-2.0 cells/μ l in month (IQR: -8.2-3.6) and was significantly associated with socio-demographic characteristics, HIV transmission mode,the first or baseline CD4+ T cell counts and the time interval between the first and the last CD4 + T cell counting tests etc. About 60.0％ (2693/4487) of the HIV/AIDS patients had deletions of CD4 + T cell counts, and 31.2％ (1400/4487) had significant ( ≥ 30％ ) deletions of CD4 + T cell counts. Results from the multiple logistic regression analysis indicated that age, ethnicity,marital status, HIV transmission mode, the first CD4+ T cell counts and the interval between the first and the last CD4+ T cell counting tests were significantly associated with the significant depletion of CD4 + T cell counts. Conclusion The changing rate of CD4 + T cell count among ART-naive local HIV-infected patients in Dehong prefecture, Yunnan province was relatively slow. However,substantial proportion of them showed significant decreases of CD4 + T cell counts, which was determined by many factors. More efforts were needed to systematically and consistently follow-up those HIV-infected patients and measure their CD4+ T cell counts in China, in order to instantaneously monitor the disease progression,and the initiation of ART, if necessary.