获得性免疫缺陷综合征患儿抗逆转录病毒治疗近期疗效及安全性研究  

Study on short-term efficacy and safety of HAART in children with HIV/AIDS

作　　者：李在村[1] 赵燕[2] 窦智慧[2] 文毅[2] 于兰[2] 吴昊[1] 张福杰[2,3] 

机构地区：[1]首都医科大学附属北京佑安医院,北京100069 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京100054 [3]北京地坛医院,北京100011

出　　处：《中国实用儿科杂志》2009年第8期618-620,共3页Chinese Journal of Practical Pediatrics

基　　金："十五"国家科技攻关计划课题资助项目(课题批准号:2004BA719A11)

摘　　要：目的研究儿童获得性免疫缺陷综合征(HIV/AIDS)抗逆转录病毒治疗(HAART)方案的近期疗效和安全性。方法2005年5月至2007年3月在中国艾滋病预防控制中心收治的经ELISA初筛、Western Blot确诊HIV感染且未接受过抗逆转录病毒治疗的患儿66例,其中男46例(69.7%),女20例(30.3%);平均年龄8.7岁(2～16岁)。HAART方案为AZT+3TC+NVP或CAT+3TC+MP。治疗12周后观察临床症状、CD4细胞计数和病毒载量的变化及治疗期间不良反应发生情况,并比较两种治疗方案疗效。结果抗病毒治疗后患儿临床表现均显著改善,身高体重增加,CD4细胞计数增长值中位数188/μL,分别有84%和52%的患儿病毒载量下降≥1Log10和<400拷贝/mL。两种方案患儿免疫学和病毒学反应差异无统计学意义。抗病毒治疗期间8例(12.1%)出现皮疹,13例(19.7%)出现ALT升高,40例应用AZT+3TC+NVP患儿中25例(62.5%)出现血红蛋白下降,无一例因药物不良反应而退出研究。结论儿童HIV/AIDS患儿HAART近期疗效良好,安全性较高,AZT+3TC+NVP方案和d4T+3TC+NVP方案同样有效。Objectives To study the short-term efficacy and safety of HAART in pediatric HIV/ADIS. Methods Totally 66 ARV-naive children with confirmed HIV infection were enrolled in this prospective observational study. After 12 weeks of treatment with either d4T＋ 3TC ＋NVP or AZT＋3TC ＋ NVP, clinical manifestations, immune response, viral response and frequencies of adverse effects were evaluated and the difference of efficacy between regimens of d4T＋3TC＋ NVP and AZT＋3TC＋NVP was analyzed. Results 1. Of 66 patients, 46（69.7%） were male and 20（30.3%） were female, with a mean age of 8.7 years （ranged 2 - 16）. 2. After 12 weeks of HAART, the clinical manifestations improved significantly. The median CD4 increase was 188/μL. Viral loads declined more than 1Log10 in 84 % of the subjects and 52% were below 400 copies/ml. 3. No subjects dropped out of the study due to adverse effects. Rash occurred in 8 （12.1%） and elevated ALT was seen in 13 （19.7%）. Among 40 subjects receiving regimen containing AZT, hemoglobin declined in 25 （62.5 % ）. Conclusion The efficacy and safety of HAART in pediatric HIV/AIDS were fairly good and HAART should be initiated as soon as possible when needed.

关 键 词：儿童 获得性免疫缺陷综合征 抗逆转录病毒治疗 疗效 安全性 

分 类 号：R72[医药卫生—儿科]