河南省接受抗病毒治疗的艾滋病患者耐药性及CD4^＋T淋巴细胞计数影响因素的研究  

Study on the correlation between HIV drug resistance and CD4^＋ T-lymphocyte of AIDS patients under antiretroviral treatment in Henan province

作　　者：朱新朋[1] 李宏[1] 刘宏伟[1] 袁源[1] 刘春华[1] 朱谦[1] 崔为国[1] 王哲[1] 

机构地区：[1]河南省疾病预防控制中心性病艾滋病防治研究所,郑州450016

出　　处：《中华流行病学杂志》2008年第12期1181-1184,共4页Chinese Journal of Epidemiology

摘　　要：目的了解河南省艾滋病病毒感染者／艾滋病患者（HIV／AIDS）高效抗病毒疗法（HAART）后HIV-1基因耐药性及患者CD4^＋T淋巴细胞计数的影响因素。方法对河南省部分HIV／AIDS进行问卷调查，采集抗凝血，检测CD4^＋T淋巴细胞绝对计数、HIV-1病毒载量，用扩增/测序（In-House）法扩增HIV-polK基因并测序，和斯坦福耐药数据库对比得到基因耐药结果。结果使用一、二代一线治疗方案的基因耐药率分别为32．21％和29．17％，差异无统计学意义（P=0．7538）；治疗时间〉2年的耐药率（33．20％）与〈1年的耐药率（18．97％）之间的差异有统计学意义（P=0．0031）。在多因素logistic回归模型分析中，年龄（OR=0．68）和领药间隔时间（OR=1．93）与耐药性的关系有统计学意义。在多因素logistic回归模型分析中，治疗方案（OR=0．51）、耐药（OR=3．20）和近1个月按时服药比例（OR=0．51）与抗病毒治疗CD4^＋T淋巴细胞计数的关系有统计学意义。结论河南省部分HIV／AIDS出现基因耐药性，应加强在发药时间、机构或人员及医生询问服药情况等方面的管理。Objective To study the correlation between genotype drug resistance and CD4^＋ T-lymphocyte of AIDS patients who received antiretroviral treatment in Henan province. Methods Several indicators were studied through questionnaires and whole blood was collected to analyze CD4^＋ T-lymphocyte as well as the virus load. In-House technique was used to detect the genotype drug resistance. Results 32.21% and 29.17 % of the patients were identified as genotype drug resistant to AIDS when used first and second generation medicine schemes but the improvement （ P = 0.7538） of disease process was not influenced much. However, if the genotype drug resistance of patients with HAART last longer than two years （33.20%） or patients with HAART less than one year （18.97%）, a greater impact on the improvement was noticed. Age （ OR = 0.68） and the interval on distribution of medicines （ OR = 1.93） had a great impact on the improvement with the genotype drug resistance through logistic regression analysis. Medicine scheme （ OR =0. 51 ）, genotype drug resistance （ OR = 3.20） and the rate of regular dose in a month （OR =0. 51 ） all had a great impact on the improvement to CD4^＋ T-lymphocyte by logistic regression analysis. Conclusion Part of HIV/AIDS patients showed resistant to genotype drugs in Henan province, suggesting that we must reinforce the surveillance on HAART and program on drug administration to the patients, in order to increase the number of CD4^＋T-lymphocyte so as to avoid the development of drug resistance.

关 键 词：人免疫缺陷病毒Ⅰ型 基因耐药性 CD4^+T淋巴细胞 

分 类 号：R51[医药卫生—内科学]