1.Changes of total HIV-1 DNA in peripheral blood mononuclear cells of HIV-1/HCV co-infected patients after HAART
Chunyan WEN ; Linghua LI ; Fengyu HU ; Haidan ZHONG ; Xizi DENG ; Weiping CAI
Chinese Journal of Clinical Infectious Diseases 2020;13(3):175-181
Objective:To analyze the dynamic changes of total HIV-1 DNA in peripheral blood mononuclear cells (PBMC) following highly active antiretroviral therapy (HAART) in HIV-1/HCV co-infected patients.Methods:Thirty patients with HIV-1/HCV co-infection without anti-HCV treatment (co-infected group) and 42 HIV-1 infected patients with initial treatment (mono-infected group) admitted to Guangzhou Eighth People’s Hospital from May 2015 to December 2017 were retrospectively analyzed. The virological and immunological responses of the two groups at 12, 24, 48, 72 and 96 weeks after HAART, the changes of total HIV-1 DNA in PBMC and its relationship with peripheral blood HIV-1 RNA and T lymphocyte subsets were observed. SPSS 22.0 statistical software was used to analyze the data.Results:The plasma HIV-1 virus inhibition rate, CD4 + T cells and CD4 + /CD8 + ratio increased and the total HIV-1 DNA in PBMC decreased in both groups after HAART. The inhibition rate of HIV RNA at week 72 in co-infected group was significantly lower than that in the mono-infected group ( χ2=7.93, P<0.01). Compared with the mono-infected group, the CD4 + T cells at week 12, 24, 72 and 96 after HAART were lower in the co-infected group ( U=313.50, 329.00, 286.00 and 204.50, P<0.05 or <0.01). The CD4 + /CD8 + ratio at week 48 in the co-infected group was lower than that in the mono-infected group ( U=294.50, P<0.05). The total HIV-1 DNA of the co-infected group at baseline and week 12 was lower than that of the mono-infected group ( U=362.00 and 359.00, P<0.01 or <0.05). There was no significant correlation between total HIV-1 DNA in PBMC and HIV-1 RNA or CD4 + /CD8 + ratio in both groups ( P>0.05). There was no correlation between total HIV-1 DNA and CD4 + T cells in HIV-1/HCV co-infected group ( b=-0.001, P>0.05), but it had negative correlation in the mono-infected group ( b=-0.001, P<0.05). Conclusion:Total HIV-1 DNA in PBMC was significantly decreased after HAART in HIV-1/HCV co-infected patients. Co-infected with HCV may delay the decrease of total HIV-1 DNA after HAART in patients with HIV-1 infection.
2.Association Between the Coexistence of Chronic Non-communicable Diseases and Quality of Life in Middle-aged and Elderly People Living with HIV/AIDS
Yao ZHANG ; Chi ZHANG ; Cong LIU ; Haidan ZHONG ; Peishan DU ; Quanmin LI ; Linghua LI ; Jing GU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):161-171
ObjectiveTo investigate the prevalence rate of chronic non-communicable diseases (NCDs) and the association with quality of life in middle-aged and elderly patients with HIV/AIDS. MethodsThis cross-sectional study surveyed 432 patients with HIV/AIDS (aged≥45 years) in the Infectious Disease Center in Guangzhou Eighth People’s Hospital of Guangzhou Medical University, and 366 participants were included in the analysis after quality control. A questionnaire and the EuroQol 5-Dimensional 3-level version (EQ-5D-3L) were used to investigate NCDs and quality of life and Tobit regression model was used to estimate the association between chronic diseases and quality of life. ResultsAmong the 366 participants, 29(7.9%) had cardiovascular disease, 45(12.3%) had hypertension, 122(33.3%) had hyperglycemia, 151(41.3%)had hyperlipidemia,7(1.9%) had cancer, 17 (4.6%) had chronic kidney disease, 38 (10.4%) had chronic liver disease, 21(5.7%) had musculoskeletal disorders, and 253(69.1%) suffered from at least one type of chronic diseases. The median (lower and upper quartiles) of EQ-5D utility index was 1.000(0.964~1.000). Multivariate Tobit regression results of the total population showed that cancer [ba=-0.08,95%CI (-0.15,-0.01),P=0.036], chronic kidney disease [ba=-0.07, 95%CI (-0.12,-0.02),P=0.006], musculoskeletal disease [ba=-0.09, 95%CI (-0.13, -0.05),P<0.001], and ≥3 types of chronic diseases[ba=-0.05, 95%CI(-0.08,-0.01),P=0.013] were negatively correlated with EQ-5D utility index. The stratified analysis results of different CD4+T cell levels showed that hypertension [ba=-0.07, 95%CI (-0.12, -0.02), P=0.007], chronic kidney disease [ba=-0.10,95%CI (-0.18,-0.03), P=0.006], musculoskeletal disease [ba=-0.15, 95%CI (-0.22,-0.07), P<0.001] and ≥3 types of chronic diseases [ba=-0.09, 95%CI (-0.09, -0.01), P<0.001] were negatively correlated with EQ-5D utility index in the group with CD4≤500 (cells/μL), whereas cancer[ba=-0.11, 95%CI (-0.20,-0.01), P=0.031] was negatively correlated with EQ-5D utility index in the group with CD4>500(cells/μL). ConclusionsThe prevalence rate of chronic non-communicable diseases in middle-aged and elderly patients with HIV/AIDS is relatively high. The classification of NCDs such as cancer or chronic kidney disease or other chronic diseases and the numbers of NCDs categories are negatively correlated with quality of life. However,this association varies among patients with HIV/AIDS of different CD4+T cell levels. It is suggested that we should try to prevent and identify NCDs at an early stage, strengthen linkages and integration of health services for AIDS and chronic NCDs, and jointly manage and control AIDS with chronic diseases to improve the quality of life among people living with HIV/AIDS.