hiv感染患者伴睡眠障碍的临床特点

Suonaa Lee, K. Park, W. J. Kim, Eun Lee
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摘要

目的:本研究旨在探讨HIV感染者(PLWH)睡眠障碍的临床特征和可能的危险因素。方法:对2012年1月1日至2021年12月31日首次诊断为HIV/AIDS且至少有一次睡眠障碍主诉的患者的研究资料,通过Severance医院临床研究分析门户(SCRAP)服务进行回顾性分析。根据是否包括失眠障碍诊断代码或是否开了失眠药物来评估睡眠障碍的存在。将患者分为3个月内睡眠障碍组(SDW3)和3个月后睡眠障碍组(SDA3)。所有数据均采用描述性统计进行报告。结果:在此期间诊断为HIV的674名患者中,56名患者至少经历过一次睡眠障碍,大约50%的患者在HIV诊断后的前3个月内经历过睡眠障碍。SDW3组患者首次出现睡眠障碍时CD4+细胞计数显著低于对照组(p=0.03),首次出现睡眠障碍时HIV病毒载量显著高于对照组(p<0.001)。与SDA3患者相比,SDW3患者的机会性感染率更高。结论:进一步研究睡眠障碍的潜在病理生理及其与免疫变化的关系,有助于早期诊断和治疗PLWH患者的睡眠障碍。
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Clinical Characteristics of HIV-Infected Patients With Sleep Disturbance
Objective: This study aims to examine clinical characteristics and to identify possible risk factors of sleep disturbances in people living with HIV (PLWH).Methods: All research data of patients who were first diagnosed with HIV/AIDS from January 1, 2012 to December 31, 2021 and complained of sleep disturbance at least once were retrospectively reviewed by the Severance Clinical Research Analysis Portal (SCRAP) service of Severance hospital. The presence of sleep disturbance was evaluated based on whether insomnia disorder diagnosis code was included or whether insomnia medication was prescribed. The patients were divided into either the group with sleep disturbance within 3 months (SDW3) and the group with after 3 months (SDA3). All data were reported using descriptive statistics.Results: Of the 674 patients diagnosed with HIV during the period, 56 patients experienced sleep disturbances at least once and approximately 50% of patients have experienced sleep disturbance in the first 3 months after HIV diagnosis. CD4+ cell count at the time of first onset of sleep disturbance was significantly lower (p=0.03) and HIV viral load at the time of first onset of sleep disturbance was significantly higher (p<0.001) in SDW3 group. SDW3 patients showed higher rates of opportunistic infections compared to SDA3 patients.Conclusion: The current study suggests that further investigation of the underlying pathophysiology of sleep disturbance and association with immunological changes for early diagnosis and treatment of sleep disturbance in PLWH.
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