广东省高效抗逆转录病毒治疗艾滋病病毒感染者/患者免疫学和病毒学评价  

Evaluation on immunological and virological effect of highly active antiretroviral therapy on HIVinfected patients in Guangdong Province

作　　者：李杰[1] 林鹏[1] 李艳[1] 杨放[1] 李俊彬[2] 刘珺[1] 黄惠珍[1] 龙其穗[1] 

机构地区：[1]广东省疾病预防控制中心,广东广州511430 [2]广州市第八人民医院

出　　处：《华南预防医学》2015年第2期113-116,共4页South China Journal of Preventive Medicine

摘　　要：目的评价广东省现行高效抗逆转录病毒治疗（HAART）方法对治疗艾滋病病毒感染者/患者（HIV/AIDS）的免疫疗效和病毒抑制疗效。方法通过中国疾病预防控制信息系统中的艾滋病综合防治信息系统收集广东省HIV/AIDS病例的HAART治疗数据信息,采用免疫学指标CD4^＋T淋巴细胞计数和病毒学指标HIV病毒载量（VL）进行评价。结果 2004—2013年共有12 886例HIV/AIDS病例接受了HAART治疗,其中男性9 393例,女性3 493例,平均年龄（40.94±11.87）岁,平均接受抗病毒治疗时间（28.17±24.28）个月。基线时CD4^＋T淋巴细胞计数〈200个/μL的患者占61.63%（7 941/12 886）,200-350个/μL的占33.08%（4 263/12 886）,〉350个/μL的占5.29%（682/12 886）。治疗后最后1次CD4^＋T淋巴细胞计数〈200个/μL的占21.32%（2 747/12 886）,200-350个/μL的占31.17%（4 017/12 886）,〉350个/μL的占47.51%（6 122/12 886）。同基线时相比,不同治疗时间病例的CD4^＋T淋巴细胞计数均明显升高,差异均有统计学意义（均P〈0.01）。12 886例病例接受HAART后,1 833例（占14.22%）VL≥400 CP/mL,病毒抑制失败;11 053例VL〈400 CP/mL,病毒抑制率为85.78%。接受HAART治疗3个月、6个月、1年、2年、3年时,病毒抑制率分别为14.42%、84.25%、91.01%、90.56%、90.86%。结论广东省HIV/AIDS对HAART有较好的病毒学及免疫学应答,现行的艾滋病HAART治疗疗效较好,应进一步提高抗病毒治疗覆盖率。Objective To evaluate the immunological and virological effect of HIV/AIDS highly active antiretroviral therapy（ HAART） program on HIV-infected patients in Guangdong. Methods Data of HAART for HIV / AIDS cases in Guangdong Province were obtained from national HIV / AIDS comprehensive information system. The effectiveness of HAART in immunity recovery and viral suppression was estimated by using CD4^＋T lymphocytes and virus load. Results A total of 12 886 AIDS patients were treated during 2004 to 2013 in Guangdong Province,including 9 393 males and 3 493 females. Their mean age was（ 40. 94 ± 11. 87） years and the mean treatment duration was（ 28. 17 ± 24. 28） months. At baseline,61. 63%（ 7 941 /12 886） of the patients had CD4^＋T lymphocytes less than 200 cells / μL,33. 08%（ 4 263 /12 886） had 200-350 cells/μL,and 5. 29%（ 682 /12 886） had more than 350 cells/μL. After HAART,21. 32%（ 2 747 /12 886） of the patients had CD4^＋T lymphocytes〈 200 cells / μL,31. 17%（ 4 017 /12 886） had 200-350 cells/μL,and 47. 51%（ 6 122 /12 886） had〉 350 cells/μL,respectively. Compared with those at baseline,the counts of CD4^＋T lymphocytes of the patients increased obviously after HAART（ P〈0. 01 for all）. Of 12 866 patients completing HAART,11 053 had HIV viral load 400 copy / mL with a viral inhibitory rate of 85. 78%. The viral inhibitory rates were 14. 42%,84. 25%,91. 01%,90. 56%,and 90. 86% in the patients after HARRT for 3 months,6 months,1 year,2 years,and 3 years,respectively. Conclusion HIV / AIDS patients in Guangdong Province showed good virological and immunological responses to HAART. The current China＇s national HAART regimens were effective and the coverage of antiviral treatment should be improved.

关 键 词：获得性免疫缺陷综合征 高效抗逆转录病毒治疗 CD4^+T淋巴细胞 病毒载量 病毒抑制率 

分 类 号：R512.91[医药卫生—内科学]