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• W4313236578 abstract "Objective: To examine characteristics and risk factors of the blood lipid trajectories among HIV-infected patients treated with antiviral therapy (ART). Methods: Based on the retrospective cohort study design, sociodemographic characteristics and baseline laboratory indicators of HIV-infected patients receiving ART from January 2004 to April 2021 in Taizhou, Zhejiang province. The blood lipid trajectories of the subjects was described and classified using the latent class mixed model (LCMM). Multivariate logistic regression was used to determine the risk factors of blood lipid trajectories. The data were analysized by R 3.5.0. software with lcmm package. Results: Among 2 079 HIV-infected patients, the median age (Q1, Q3) was 31 (43, 55) years, and the majority were being male (78.1%, 1 623/2 079) and married (58.7%, 1 221/2 079). BMI ≥24.0 kg/m2 accounted for 18.9% (393/2 079). Heterosexual transmission accounted for 67.7% (1 407/2 079). Three different blood lipid trajectories were classified: inverted U-shaped (2.3%, 48/2 079), progressive (31.3%, 650/2 079), and general trajectory (U-shaped) (66.4%, 1 381/2 079). The inverted U-shaped and progressive trajectory are identified as dangerous trajectories (33.6%). Multivariate logistic regression analysis indicated that compared with 3TC-TDF-EFV antiviral treatment regimen, baseline TC level <5.2 mmol/L, baseline TG level <1.7 mmol/L, BMI 18.5-23.9 kg/m2, baseline CD4+T lymphocytes (CD4) counts <200 cells/μl, antiviral treatment time <5 years,those who had been using 3TC-AZT-EFV antiviral therapy regimen (aOR=1.99,95%CI:1.44-2.77) and those who switched to LPV/r antiviral therapy regimen (aOR=3.17, 95%CI: 2.00-5.01), baseline TC levels were 5.2-6.1 mmol/L (aOR=2.55, 95%CI: 1.92-3.39) and ≥6.2 mmol/L (aOR=5.89,95%CI:3.76-9.25), and baseline TG levels were 1.7-2.2 mmol/L (aOR=2.00, 95%CI: 1.53-2.62) and ≥2.3 mmol/L (aOR=6.51,95%CI:4.97-8.54), respectively, BMI ≥24.0 kg/m2 (aOR=1.44, 95%CI: 1.11-1.88) were more likely to show the dangerous trajectories. BMI <18.5 kg/m2 (aOR=0.55, 95%CI: 0.35-0.86), baseline CD4 counts level was 200-349 cells/μl (aOR=0.67, 95%CI: 0.52-0.87) and baseline CD4 ≥350 cells/μl (aOR=0.71, 95%CI: 0.54-0.94). The duration of antiviral therapy was 5-9 years (aOR=0.74, 95%CI: 0.56-0.99), and ≥10 years (aOR=0.53, 95%CI: 0.22-0.67) were less likely to show the dangerous trajectories. Conclusions: HIV-infected patients showed a dangerous trajectory of blood lipids after ART, which was significantly associated with the use of specific antiviral drugs such as AZT and LPV/r, treatment duration, baseline CD4, TC, TG levels and BMI. It is recommended to strengthen blood lipid monitoring and targeted intervention measure when HIV infected persons start antiviral treatment.目的： 分析抗病毒治疗HIV感染者血脂变化轨迹特征及其影响因素。 方法： 基于回顾性队列研究设计，以浙江省台州市2004年1月至2021年4月抗病毒治疗HIV感染者为研究对象，运用χ2检验分析研究对象社会人口学特征和基线指标情况，应用潜在类别混合模型描述研究对象接受抗病毒治疗后血脂变化轨迹，采用多因素logistic回归分析血脂变化轨迹的影响因素。采用R 3.5.0.软件LCMM软件包进行统计学分析。 结果： 2 079例HIV感染者中，年龄M（Q1，Q3）为31（43，55）岁，以男性（78.1%，1 623/2 079）和已婚（58.7%，1 221/2 079）为主，BMI≥24.0 kg/m2占18.9%（393/2 079），异性性传播途径占67.7%（1 407/2 079）。血脂变化轨迹分为3种：倒U形（2.3%，48/2 079）、进展型（31.3%，650/2 079）和一般轨迹（U形）（66.4%，1 381/2 079），倒U形和进展型确定为危险轨迹（33.6%）。多因素logistic回归分析结果显示，相比于抗病毒治疗方案为齐多夫定-替诺福韦-依非韦伦（3TC- TDF-EFV）、基线TC水平<5.2 mmol/L、基线TG水平<1.7 mmol/L、BMI为18.5~23.9 kg/m2、基线CD4+T淋巴细胞（CD4）计数<200个/μl和抗病毒治疗时间<5年者，抗病毒治疗方案一直使用齐多夫定-拉米夫定-依非韦伦（3TC-AZT-EFV）（aOR=1.99，95%CI：1.44~2.77）和更换为克力芝（LPV/r）（aOR=3.17，95%CI：2.00~5.01）、基线TC水平分别为5.2~6.1 mmol/L（aOR=2.55，95%CI：1.92~3.39）和≥6.2 mmol/L（aOR=5.89，95%CI：3.76~9.25）、基线TG水平分别为1.7~2.2 mmol/L（aOR=2.00，95%CI：1.53~2.62）和≥2.3 mmol/L（aOR=6.51，95%CI：4.97~8.54）、BMI为≥24.0 kg/m2（aOR=1.44，95%CI：1.11~1.88）的HIV感染者较容易出现血脂变化的危险轨迹。而BMI 为<18.5 kg/m2（aOR=0.55，95%CI：0.35~0.86）、基线CD4计数为200~349个/μl（aOR=0.67，95%CI：0.52~0.87）和≥350个/μl（aOR=0.71，95%CI：0.54~0.94）、抗病毒治疗时长为5~9年（aOR=0.74，95%CI：0.56~0.99）和≥10年（aOR=0.53，95%CI：0.22~0.67）的HIV感染者较不容易出现血脂变化的危险轨迹。 结论： 部分HIV感染者抗病毒治疗后的血脂变化呈危险轨迹状态，与AZT和LPV/r等特定抗病毒药物使用、抗病毒治疗时长、基线CD4计数、TC、TG和BMI显著关联，建议HIV感染者开始抗病毒治疗阶段的同时，加强血脂监测并采取针对性干预措施。." @default.
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• W4313236578 date "2022-12-10" @default.
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• W4313236578 title "[Characteristics and associated factors of blood lipid trajectories among HIV-infected patients receiving antiretroviral therapy]." @default.
• W4313236578 doi "https://doi.org/10.3760/cma.j.cn112338-20220703-00586" @default.
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