HIV/AIDS病人初始抗病毒治疗效果与病毒载量检测频率的分析  

Effect of viral load monitoring frequency on the treatment of patients with initial ART

作　　者：聂欢 赵攀[1] 王静[1] 白艳[1] 唐德谊 肖文秀[1] 陈思源[1] 黄成瑜 

机构地区：[1]重庆市公共卫生医疗救治中心,重庆400036

出　　处：《中国艾滋病性病》2016年第7期503-505,517,共4页Chinese Journal of Aids & STD

基　　金：中国爱之关怀项目基金~~

摘　　要：目的探索病毒载量(VL)检测频率,对初始抗病毒治疗(ART)的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)治疗效果的影响。方法选取2013年11月至2014年8月,在重庆市公共卫生医疗救治中心就诊并接受抗病毒治疗的HIV/AIDS病人,分为VL检测低频组(检测次数≤2次/年)和VL检测高频组(检测次数≥3次/年),进行随访观察。收集两组病人的基线资料,同时记录两组病人治疗一年后VL的变化、CD4+T淋巴细胞(简称CD4细胞)的变化、换药情况和机会性感染发生情况。结果 VL检测高频组入组422例,VL检测低频组入组145例,两组病人基线情况在性别、年龄、婚姻状况、感染途径、基线CD4细胞计数水平、文化程度及经济水平方面的差异均无统计学意义。半年后CD4细胞水平变化,VL检测高频组高于VL检测低频组(P<0.05)。治疗一年后,两组VL检测结果在不同VL区间的分布差异无统计学意义,VL检测高频组换药率低于低频组(P<0.05),监测到机会性感染发生率VL检测高频组高于低频组(P<0.05)。结论对初始ART的病人进行较高频率的VL检测,可以提高治疗的临床效果。Objective To explore the benefits of viral load（VL）monitoring frequency for HIV patients with initial antiretroviral therapy（ART）.Method HIV-infected or AIDS patients who underwent routine viral load determination were included in this analysis in Chongqing infectious disease medical center,between Nov 2013 and Aug2014.Patients were divided into two groups（frequent testing group≥3times/year and less frequent testing group≤2times/year）.Data of virus load,CD4 count,treatment switching and opportunistic infections were collected.Results 422 participants were defined in frequent testing group and 145 were in less frequent testing group.It was found that the baseline information of the patients,such as gender,age,marital status,education,family economic status,HIV-infected route and baseline CD4 cell counts was similar between the two groups.After 6 months of ART,the change of CD4 cell counts in frequent testing group was significantly higher than that of the less frequent testing group（P〈0.05）.After a year of ART,the treatment switching in frequent testing group was significantly lower than that of the less frequent testing group（P〈0.05）.The opportunistic infections in frequent testing group was significantly higher than that of the less frequent testing group（P〈0.05）.Conclusion The high frequency of VL monitoring can improve the clinical effect.

关 键 词：艾滋病病毒感染者/艾滋病病人 抗病毒治疗 病毒载量检测 CD4+T淋巴细胞计数 换药 机会性感染 

分 类 号：R373.9[医药卫生—病原生物学] R512.91[医药卫生—基础医学]