182例HIV/AIDS实施高效抗反转录病毒治疗的疗效评价  

Evalution of highly active antiretroviral therapy in 182 patients with HIV/AIDS

作　　者：张乃春[1] 赵鹏[1] 许洪新[1] 闫慧颖[1] 赵敏[1] 

机构地区：[1]北京大学解放军第三〇二医院教学医院感染性疾病诊疗与研究中心,100039

出　　处：《传染病信息》2014年第6期350-353,共4页Infectious Disease Information

基　　金：国家"十二五"科技重大专项(2012ZX10001003)

摘　　要：目的分析182例HIV/AIDS实施高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)的效果及其影响因素,为进一步有效治疗提供依据。方法采用回顾性调查方法,对我院接受规范HAART的182例HIV/AIDS患者的CD4+T淋巴细胞绝对计数和病毒载量进行分析。结果 182例中,157例治疗后CD4+T淋巴细胞计数增加,且在治疗后前6个月内增加速度最快,随着治疗时间延长则较为缓慢。病毒载量在治疗后的6个月内下降最快,大部分降至血浆检测不到的水平,6个月后比较稳定;但随着治疗时间延长,部分患者的病毒载量出现反弹,可能与患者服药依从性差和病毒耐药性的出现有关。治疗前后CD4+T淋巴细胞计数差异有统计学意义(P<0.05)。多因素logistic回归分析表明年龄和病毒载量是影响HAART疗效的危险因素,基线CD4+T淋巴细胞计数和按时服药是保护因素。结论 HAART能明显增加CD4+T淋巴细胞计数,降低病毒载量,有效控制机会感染,治疗效果显著。影响HAART疗效的因素是多方面的,在治疗过程中应综合考虑各种可能影响因素以提高疗效,对符合条件的患者应尽早进行规范的抗病毒治疗。Objective To evaluate the therapeutic efficacy of highly active antiretroviral therapy （HAART） and its influencing factors in 182 patients with HIV/AIDS, so as to provide the evidence for effective treatment of HIV/AIDS. Methods All the cases were analyzed retrospectively. CD4^＋ T lymphocyte counts and viral load of 182 patients with HIV/AIDS receiving HAART in our hospital were detected and analyzed. Results Of 182 patients, 157 showed an increase in CD4^＋ T lymphocyte counts after starting HAART, and the CD4^＋ T lymphocyte counts increased most rapidly in the first 6 months of HAART, while they increased relatively slowly as time of receiving HAART prolonged. In addition, viral load decreased most rapidly in the first 6 months of HAART, with undetectable level in plasma of the most patients, and it kept relatively stable after 6 months of HAART. However, viral load rehounded in some patients as time of receiving HAART prolonged, probably due to poor medication adherence or occurrence of drug resistance. CD4^＋ T lymphocyte counts were significantly different between pretherapy and post-therapy （P〈0.05）. Multivariate logistic regression analysis showed that age and viral load were the risk factors affecting the efficacy of HAART, and baseline CD4^＋ T lymphocyte counts and taking antiviral drugs on time were the protective factors. Conclusions The efficacy of HAART is remarkable in significantly increasing CD4^＋ T lymphocyte counts, reducing viral load, and effectively controlling opportunistic infections. However, there are a variety of factors affecting the efficacy of HAART, so the possible influencing factors should be taken into consideration in the process of treatment, and eligible patients should be given standard HAART as soon as possible.

关 键 词：HIV 获得性免疫缺陷综合征 抗逆转录病毒治疗 高效 病毒载量 

分 类 号：R373.51[医药卫生—病原生物学] R512.91[医药卫生—基础医学]