Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /106 PBMCs) before ART, and droped rapidly (<400 copies /106 PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/106 PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.
目的： 分析云南省德宏傣族景颇族自治州（德宏州）HIV感染者抗病毒治疗后HIV-1 DNA载量的动力学变化及影响因素，为HIV-1 DNA定量检测的临床应用提供参考依据。 方法： 研究对象来源于德宏州CDC建立的2009-2018年HIV新发感染队列，构建HIV-1 DNA载量随抗病毒治疗时间动力学变化曲线图。采用logistics回归模型进行抗病毒治疗后最近1次随访的HIV-1 DNA载量值的影响因素分析。采用SPSS 17.0软件进行统计学分析。 结果： 新发队列113例HIV感染者中，HIV新发感染者占49.6%（56/113），男性、性传播和注射吸毒传播分别占53.1%（60/113）、80.5%（91/113）和19.5%（22/113）。抗病毒治疗前，HIV-1 DNA载量值较高（>800 拷贝/106 PBMCs）；抗病毒治疗1年后，HIV-1 DNA载量值迅速下降至<400 拷贝/106 PBMCs；随着抗病毒治疗的持续进行，HIV-1 DNA载量值下降不明显，第6年载量值仍维持在269 拷贝/106 PBMCs。进行HIV-1感染者抗病毒治疗后最近1次随访HIV-1 DNA载量值的影响因素分析，单因素logistics回归分析结果显示，基线CD8、基线CD4/CD8和基线HIV-1 DNA载量值OR值（95%CI）分别为1.00（1.00~1.00）、0.30（0.09~1.05）和1.01（1.00~1.01），多因素logistics回归分析结果显示，基线HIV-1 DNA载量值的OR值（95%CI）为1.00（1.00~1.01）。 结论： 在抗病毒治疗后第1年内，HIV-1 DNA载量值下降显著，随后下降到一定水平之后保持稳定，该水平与HIV-1 DNA载量值基线密切相关，基线越低，HIV-1 DNA载量值水平越低。感染HIV后尽早开始抗病毒治疗，有利于控制HIV-1 DNA载量值。.