吉林市HIV/AIDS患者病程及抗病毒效果评价  

Study on disease progression and efficacy of highly active antiretroviral therapy in HIV/AIDS patients in Jilin city

作　　者：刘宝贵[1] 刘静[2] 李秀金 王亚男[2] 张子宁[2] 刁莹莹[2] 代娣[2] 姜拥军[2] 尚红[2] 

机构地区：[1]吉林省吉林市疾病预防控制中心性病艾滋病防治科,132001 [2]中国医科大学附属第一医院艾滋病研究所 [3]吉林省舒兰市疾病预防控制中心

出　　处：《中国公共卫生》2005年第11期1291-1293,共3页Chinese Journal of Public Health

基　　金：科技部重大基础研究前期研究专项课题(2004CCA02000)

摘　　要：目的研究吉林市93例HIV感染者/AIDS病人疾病进展情况;采用高效抗逆转录病毒治疗(HAART)的疗效,为HIV/AIDS综合防治措施提供科学依据。方法通过现场流行病学调查分析HIV感染者/AIDS病人一般情况,检测抗丙型肝炎病毒(HCV)抗体,定期进行CD4+、CD8+T淋巴细胞绝对计数检测以监测疾病进展,用HAART治疗HIV感染者/AIDS病人,监测病毒学及免疫学变化,观察抗病毒药物的毒副作用及服药依从性。结果吉林市93例HIV感染者/AIDS病人中86例(92.5%)经血液感染且合并HCV感染。估计感染时间在8年以上者88例,其中20.5%CD4+T淋巴细胞数<200/mm3,50%为200~500/mm3,29.5%>500/mm3。接受HAART治疗的23例HIV感染者/AIDS病人治疗前平均病毒载量为5.06 log拷贝/ml(4.39×105拷贝/ml),治疗12个月后平均下降3.47log拷贝/ml(P<0.001),其中16例达到检测不出的水平(<400拷贝/ml),CD4+T淋巴细胞数平均上升48个/mm3(P<0.05)。结论吉林市存在部分疾病进展缓慢的HIV感染者;HAART治疗取得了较好的疗效,但司他夫定和去羟肌苷联合应用使周围神经病变发生率较高;加强对感染者疾病进展和抗病毒疗效及不良反应监测,有助于确定开始抗病毒治疗的时机和及时调整治疗方案。Objective To evaluate disease progression and efficacy of highly active antiretroviral therapy(HAART) in 93 HIV/AIDS patients in jinlin city,and to provide scientific basis to work out a guideline for prevention and control of HIV/AIDS in China. Methods 93 HIV-seropositive individuals were enrolled in a prospective study.Anti-HCV was detected by ELISA method.Disease progression was determined by detecting CD^+_4Tcell counts every three months.Viral load,CD^+_4T cell counts,clinical manifestations,drug related adverse events and adherence were monitored for HIV/AIDS patients receiving HAAER during 52 weeks follow-up. Results In 93 HIV-1 infected individuals,92.5%(86/93) were HCV antibody positive and infected through illegal donation blood.88 individuals infected HIV over 8 years,the percentage of patients with baseline CD^+_4T cell counts<200 cells/mm^3,200～500cells/mm^3 were 20.5%,50%,29.5% respectively.The mean viral load of 23HIV/AIDS patients receiving HAART was 5.06log copies/ml(4.39×10~5copies/ml) at baseline and decreased 3.47log copies/ml after 52 weeks treatment(P<0.001) and the viral load level of 70% (16/23) patients became undetectable(<400copies/ml).The mean CD^+_4T cell counts of the 23 patients increased 48cells/mm^3 after 52 week treatment(P<0.05). Conclusion There are some HIV-1infected individuals with delayed disease progression in Jilin city.HAART is effective in reducing HIV-RNA and improving immune functions at 52 weeks,but the rate of peripheral neuropathy is high by combining Didanosine(ddI) and Stavudine(d4T).Monitoring clinical progression and efficacy HAART are important for antiretroviral therapy initation and regimen adjustment.

关 键 词：人类免疫缺陷病毒 高效抗逆转录病毒治疗(HAART) 疾病进展 

分 类 号：R512.91[医药卫生—内科学]