RESUMO
Objective:To understand the incidence of sleep disorder in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients before antiviral therapy, and to explore its risk factors.Methods:200 newly treated HIV/AIDS patients who visited the Eighth Affiliated City Hospital of Guangzhou Medical University from January to June 2016 were randomly selected. According to the Pittsburgh Sleep Quality Index (PSQI), they were divided into a good sleep group and a Sleep disorder group; The influencing factors of sleep disorder in HIV/AIDS patients were analyzed by univariate analysis and multivariate logistic regression.Results:The incidence of Sleep disorder in 200 HIV/AIDS patients before antiviral therapy was 22.5%(45/200); CD4 + T cell count was (414.13±202.16)/μl; 29%(58/200) of patients had CD4 + T cell counts<200/μl. There were significant differences in CD4 + T cell count and the proportion of patients with syphilis infection, comorbidity anxiety and comorbidity depression between the good sleep group and the Sleep disorder group (all P<0.05). Multivariate logistic regression analysis showed that syphilis infection ( OR=4.606; 95% CI: 1.973-10.752; P<0.001), comorbidity anxiety ( OR=2.496; 95% CI: 1.086-5.737; P=0.031) and comorbidity depression ( OR=2.087; 95% CI: 0.915-4.760; P=0.040) were risk factors for sleep disorder in HIV/AIDS patients before antiviral treatment. Conclusions:The incidence of Sleep disorder in HIV/AIDS patients before antiviral therapy in Guangzhou is high, especially in patients with syphilis infection, comorbidity anxiety and comorbidity depression. The sleep disorder of HIV/AIDS patients should be assessed and detected early, and multiple interventions should be taken to improve sleep quality.
RESUMO
Rationale and objective: COVID-19 vaccination is the most effective way to prevent COVID-19. For chronic kidney disease patients on long-term dialysis, there is a lack of evidence on the pros and cons of COVID-19 vaccination. This study was conducted to investigate the immunogenicity and safety of COVID-19 vaccines in patients on dialysis. Methods: PubMed, MEDLINE, EMBASE, and the Cochrane Library were systemically searched for cohort, randomized controlled trials (RCTs), and cross-sectional studies. Data on immunogenicity rate, antibody titer, survival rate, new infection rate, adverse events, type of vaccine, and patient characteristics such as age, sex, dialysis vintage, immunosuppression rate, and prevalence of diabetes were extracted and analyzed using REVMAN 5.4 and Stata software. A random effects meta-analysis was used to perform the study. Results: We screened 191 records and included 38 studies regarding 5,628 participants. The overall immunogenicity of dialysis patients was 87% (95% CI, 84-89%). The vaccine response rate was 85.1 in hemodialysis patients (HDPs) (1,201 of 1,412) and 97.4% in healthy controls (862 of 885). The serological positivity rate was 82.9% (777 of 937) in infection-naive individuals and 98.4% (570 of 579) in patients with previous infection. The Standard Mean Difference (SMD) of antibody titers in dialysis patients with or without previous COVID-19 infection was 1.14 (95% CI, 0.68-1.61). Subgroup analysis showed that the immunosuppression rate was an influential factor affecting the immunogenicity rate (P < 0.0001). Nine studies reported safety indices, among which four local adverse events and seven system adverse events were documented. Conclusions: Vaccination helped dialysis patients achieve effective humoral immunity, with an overall immune efficiency of 87.5%. Dialysis patients may experience various adverse events after vaccination; however, the incidence of malignant events is very low, and no reports of death or acute renal failure after vaccination are available, indicating that vaccine regimens may be necessary. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022342565, identifier: CRD42022342565.
