云南省艾滋病关爱中心儿童艾滋病抗病毒治疗现状分析  

Current status of anti-viral treatment in children with acquired immune deficiency syndrome in acquired immune deficiency syndrome care center, Yunnan

作　　者：谢荣慧 张福杰[2] 李惠琴 汪习成 桂琳 杨静 毕雄凤 

机构地区：[1]云南省传染病专科医院艾滋病关爱中心,昆明650033 [2]北京地坛医院感染科

出　　处：《中华传染病杂志》2017年第7期407-410,共4页Chinese Journal of Infectious Diseases

摘　　要：目的分析儿童长期抗病毒治疗效果，探索影响儿童抗病毒疗效及生长发育的因素，为提高抗病毒治疗效果提供参考。方法采用回顾性分析的方法，对2004年至2016年入组抗病毒治疗的艾滋病儿童进行统计学分析，每半年统计身高、体质量、CD4^＋T淋巴细胞计数，每年统计HIV RNA载量。比较治疗〈1年、1～〈5年、5～〈10年、≥10年以上儿童CD4＋T淋巴细胞计数及病毒抑制率，评价其生长发育状况。比较社会组织抚养、家庭抚养儿童的疗效及生长发育情况，家庭抚养儿童又分高收入家庭、低收入家庭并进行比较。计数资料比较采用χ^2检验，非正态分布资料比较采用轶和检验。结果抗病毒疗程1～5年（含5年）与5～10年（含10年）的患儿比较，基线CD4^＋T淋巴细胞计数分别是437（265，728）个/μL和334（102，535）个/μL，两组比较差异有统计学意义（Z＝－2.619，P〈0.01）。末次CD4^＋T淋巴细胞计数分别是779（622，1 024）个/μL和720（640，977）个/μL，两组比较差异无统计学意义（Z＝－0.708，P〉0.05）；病毒抑制率分别为92.9%和97.6%，两组比较差异无统计学意义（χ^2＝1.071，P＝0.393）；治疗第1年的儿童病毒抑制率为85.7%，治疗10年以上儿童病毒抑制率为100.0%；5例耐药（2例疗程1～5年，3例疗程5～10年），更换了洛匹那韦/利托那韦后病毒得到完全抑制；全部儿童服药依从性均〉95.0%。64.8%的儿童达到标准身高，68.5%的儿童达到标准体质量；家庭抚养儿童和社会组织抚养儿童的基线、末次CD4^＋T淋巴细胞计数比较差异均无统计学意义（Z值分别为－1.159和－0.523，均P〉0.05）；高收入家庭和低收入家庭的儿童基线和末次CD4^＋T淋巴细胞计数比较差异均无统计学意义（Z值分别为－0.019和－0.776，均P〉0.05）。结论儿童长期抗病毒治疗能有效提升CD4^＋T淋巴细胞水平、抑制�ObjectiveTo analyze the effect of long-term anti-viral treatment in children with acquired immune deficiency syndrome （AIDS） and investigate the factors affecting the treatment efficacy and growth and development of the children, so as to provide reference for improving the efficacy of antiviral drugs.MethodsChildren with AIDS receiving anti-retroviral treatment during 2004 to 2016 were retrospectively enrolled. The height, weight and CD4^＋ T cell counts were recorded every half year and the measurement of HIV RNA load was recorded on an annual basis. The CD4^＋ T cell counts and viral inhibition rates for the children who were under the treatment in the first year, 1~〈5 years, 5~〈10 years, and ≥10 years were compared. And their growth and development were also assessed. Treatment efficacy and growth and development of the children were compared between those who raised by social organization and by family. Children who raised by family were further divided into two groups： high-income and low-income groups. All categorical data were analyzed using chi-square test and those non-normal distribution were compared by rank-sumtest.ResultsAfter comparison between the children who have received anti-virus treatment for 1 to 5 years （including 5 year） and those for 5 to 10 year （including 10 years）, the baseline CD4^＋ T cell counts were 436.5（265, 728）cells/μL and 334 （102, 535）cells/μL, respectively with the statistically significant difference （Z=-2.619, P〈0.01）. The last measured CD4^＋ T cell counts were 779 （622, 1 024）cells/μL and 720 （640, 977）cells/μL, respectively with no statistical significance （Z=-0.708, P〉0.05）; and viral inhibition rates were 92.9% and 97.6%, respectively with no statistical significance （χ^2=1.071, P〉0.05）. The viral inhibition rate for the children receiving the treatment for 1 year was 85.7%, while that for whose treatment lasted for more than 10 years was 100.0%. A total of 5 cases developed drug-resistance （2 cases tre

关 键 词：艾滋病 儿童 抗逆转录病毒治疗 高效 疗效 现状 

分 类 号：R725.1[医药卫生—儿科]