Study On The Correlation Between The Changes Of Laboratory Indexes And Survival Of HIV/AIDS Patients After Antiviral Therapy

Objective:By analyzing the differences and distribution characteristics of laboratory indicators in different genders,ages,survival outcomes and treatment regimens of HIV/AIDS patients after antiretroviral therapy,and their relationship with each other,the changes of laboratory indicators were explored to reveal the impact of these changes on the survival of patients.Methods:A total of 1621 HIV/AIDS patients who received antiretroviral therapy in our hospital from 2005 to 2020 were enrolled in this study.Firstly,the general demographic characteristics of HIV/AIDS patients were described and analyzed.Secondly,the differences in laboratory indicators of HIV/AIDS patients with different genders,ages,survival outcomes and antiviral treatment regimens were analyzed.The laboratory indicators of 25 HIV/AIDS patients with the earliest entry time and longest survival time were analyzed with the change trend of treatment time.Logistic regression was used to analyze the influencing factors of survival of HIV/AIDS patients.Finally,the influence of different antiretroviral therapy on HIV/AIDS patients was analyzed.Results:1、The 1621 HIV/AIDS patients included in the study were mainly middle-aged,male and sexually transmitted.There were significant differences in gender,age distribution,duration of antiviral therapy and route of infection between the surviving patients and the dead patients（P<0.05）,but no significant differences in marital status（P>0.05）.2、There were statistically significant differences in hemoglobin,serum creatinine,aspartate aminotransferase and alanine aminotransferase between the survival and death patients and the healthy control group（P<0.05）.Compared with the healthy control group,the fasting blood glucose level of the death patients was significantly increased,and the difference was statistically significant（P<0.05）.There were significant differences in viral load and CD₄⁺T lymphocytes between survival and death patients（P<0.05）.3、There were significant differences in platelet,hemoglobin,aspartate aminotransferase,alanine aminotransferase and total bilirubin between male and female survival patients and healthy control group（P<0.05）.There were statistically significant differences in hemoglobin,serum creatinine,aspartate aminotransferase and alanine aminotransferase between male and female dead patients and healthy controls（P<0.05）.4、There were significant differences in platelet and serum creatinine levels among young,middle-aged and elderly patients（P<0.05）.The older the age,the lower the platelet count,and the higher the serum creatinine level.There were significant differences in triglyceride levels among young,middle-aged and elderly patients（P<0.05）.Triglyceride levels were highest in middle-aged patients,followed by the elderly and the young.5、Twenty-five surviving HIV/AIDS patients were treated with antiviral therapy for up to 15 years.The Viral load of the patients were suppressed,the immune function was recovered,and the serum creatinine,aspartate aminotransferase and alanine aminotransferase gradually returned to normal reference range from abnormally high.Levels of white blood cells,platelets,hemoglobin,total cholesterol,fasting blood glucose and total bilirubin varied within normal limits,and triglyceride levels were above the normal reference range.6、Multivariate Logistic regression analysis showed that baseline viral load,CD₄⁺T lymphocytes,hemoglobin and aspartate aminotransferase were associated with the survival of HIV/AIDS patients.White blood cells,platelets,hemoglobin,serum creatinine,total cholesterol,fasting blood glucose and aspartate aminotransferase have influence on the survival of HIV/AIDS patients after antiviral therapy.7、The platelet count of patients with 3TC+AZT+EFV regimen was significantly higher than that of patients with other regiments,and the serum creatinine level was lower than that of patients with other regiments.The triglyceride level of patients with 3TC+AZT+NVP and 3TC+TDF/AZT+LPV/r regimen gradually increased with the depth of treatment,and the 3TC+TDF+EFV regimen had the least effect on the triglyceride level of patients.The levels of aspartate aminotransferase and alanine aminotransferase in patients with 3TC+AZT+NVP regimen always fluctuated within the normal reference range,and the levels of aspartate aminotransferase and alanine aminotransferase in patients with other three treatment regiments were higher than the normal reference level in the initial period of treatment.The total bilirubin level of patients with 3TC+TDF/AZT+LPV/r regimen gradually increased with treatment time.Conclusion:1、In the long-term antiviral treatment,in addition to the factors such as viral load and CD₄⁺T lymphocytes,the patient has complications such as liver disease,kidney disease,abnormal glucose metabolism,abnormal lipid metabolism,hemorrhage and anemia,which are also important factors affecting the survival of the patient.2、In the course of antiviral treatment,male patients are more likely to suffer from liver and kidney damage and abnormal blood lipid metabolism,while female patients are more likely to suffer from anemia;Young patients are prone to liver function injury,middle-aged patients are prone to liver function injury,bleeding,diabetes,and elderly patients are prone to dyslipidemia and kidney disease.3、3TC+AZT+EFV treatment regimen is the best for patients with low CD₄⁺T lymphocyte count,and 3TC+AZT+NVP treatment regimen is beneficial to patients’ liver function.However,different antiviral treatment schemes have different effects on patients.We should regularly monitor patients’ laboratory indicators,evaluate the risk of complications,select appropriate treatment schemes,and extend the survival period of patients.