Analysis of the clinical characteristics of poor immunological reconstitution in AIDS patients after long-term antiviral therapy in Xinjiang, China

To investigate the clinical characteristics of poor immunological reconstitution in AIDS patients after long-term antiviral therapy in the Xinjiang region and to analyze the possible factors leading to poor immunological reconstitution. We enrolled 735 AIDS patients who received HAART and followed up for at least 96 weeks at the Infection and Liver Disease Center of the First Affiliated Hospital of Xinjiang Medical University from March 2004 to February 2021. The clinical characteristics of all patients were summarized, and univariate and multivariate statistical analyses were performed on general conditions, clinical data, laboratory tests, and other factors. Among the 735 patients, 506 were male (68.8%) and 229 were female (31.2%). The average age was 40.11 ± 11.88 years. The incidence rate of poor immunological reconstitution was 12.7% (94 patients). Univariate analysis showed that age at the start of antiviral therapy (P < 0.05), presence of opportunistic infections in the last three months (P < 0.05), herpes zoster symptoms before treatment (P < 0.05), WHO clinical staging (P < 0.05), and lower levels of CD4 + T lymphocyte count, CD4/CD8 ratio, lymphocyte count, hemoglobin, and albumin were significant factors. Multivariate logistic regression identified presence of herpes zoster (OR = 5.668, 95% CI: 2.312–12.769, P < 0.01), lower CD4 + T lymphocyte count (OR = 0.008, 95% CI: 0.002–0.027, P < 0.01), and reduced albumin levels (OR = 3.428, 95% CI: 1.487–7.896, P < 0.01) as independent risk factors. Early intervention and comprehensive assessment are essential to reduce the incidence of poor immunological reconstitution, providing insights for clinical practice and public health strategies.