CD4(+) T Cell Count Progress and Influencing Factors of Recovery in AIDS Patients with Virological Failure in Sichuan Province: A Retrospective Cohort Study.

Background: Choosing patients with HIV/AIDS (PLWH) with virologic failure observed in the course of treatment, and analyzing the CD4(+) T cell count of PLWH with different subtypes of virus and the risk factors of CD4 (+) T cell count recovery.

Methods: Analyze and evaluate the change of median CD4(+) T cell count of PLWH infected with different HIV-1 subtypes in Sichuan Province after treatment by rank sum test. Univariate and multivariate logistic regression models were used to analyze the risk factors on CD4(+) T cell count growth after PLWH treatment.

Results: A total of 4977 cases were analysed, including CRF07_BC 2358 cases (47.38%), CRF01_AE 1507 cases (30.28%), CRF08_BC 577 cases (11.59%), CRF85_BC 303 cases (6.09%) and other subtypes 232 cases (4.66%). PLWH infected with CRF85_BC had lower median CD4(+) T cell count after treatment (p < 0.05). It was found that protective factors to increase CD4(+) T cell count (p < 0.05) including females, Yi people, married or cohabiting, educational level at primary school or above, initial and recent treatment with Tenofovir + Lamivudine + Nevirapine Wellen, the second-line regimen with lopinavir/ritonavir (LPV/r) and the treatment time is more than 24 months. However, over 50 years old, the disease course is in AIDS stage, the infection of CRF01_AE and CRF85_BC virus was the risk factor on CD4(+) T cell count increase (p < 0.05). PLWH with higher initial CD4 level had a lower ratio of CD4(+) T cell count increase (≥50 cells/μL) (p < 0.05).

Conclusion: Age, sex, ethnicity, marriage, education, disease status, treatment protocols, treatment time, initial CD4(+) T cell count, and virus subtype are the influencing factors of PLWH CD4(+) T cell count increase. The poor recovery of CD4(+) T cell count after treatment was observed in PLWH infected with CRF85_BC virus.