怀化市艾滋病患者抗病毒治疗效果及耐药影响因素分析  

Anti-retroviral therapeutic effect and factors influencing drug resistance in HIV/AIDS patients in Huaihua city

作　　者：于红缨[1] 李勇忠[1] 卫学丰[2] 刘立亚 谢知兵[1] 王培[1] YU Hong-ying;LI Yong-zhong;WEI Xue-feng;LIU Li-ya;XIE Zhi-bing;WANG Pei(The First People1 s Hospital of Huaihua City,Huaihua,Hunan 418000,China;Huaihua Municipal Center for Disease Control and Prevention,Huaihua,Hunan 418000,China;School of Laboratory Medicine,Hunan University of Medicine,Huaihua,Hunan 418000,China)

机构地区：[1]怀化市第一人民医院,湖南怀化418000 [2]怀化市疾病预防控制中心,湖南怀化418000 [3]湖南医药学院检验医学院,湖南怀化418000

出　　处：《实用预防医学》2020年第4期455-459,共5页Practical Preventive Medicine

基　　金：吉首大学校级自然科学研究项目(吉大发[2018]22号)。

摘　　要：目的了解怀化市艾滋病患者接受抗病毒治疗的效果及耐药状况,分析影响耐药产生的相关因素。方法对就诊于怀化市第一人民医院艾滋病门诊及病房的抗病毒治疗时间超过1年,且年龄为18岁以上的367例HIV感染者及AIDS患者,检测CD4^+T淋巴细胞和病毒载量,对病毒载量大于1000 copies/ml的标本进行HIV耐药基因型检测分析,并分组对治疗前CD4^+T淋巴细胞水平、治疗依从性等级及抗病毒治疗期间合并应用抗结核药物的比例进一步统计分析。结果86.65%的治疗者采用一线治疗方案,92.37%的治疗者达到病毒学抑制,7.63%的治疗者出现病毒学失败,13.89%的治疗者CD4^+T淋巴细胞低于200个/μl,18例治疗者发生耐药,耐药发生率4.90%。耐药组与非耐药对照组在治疗前CD4^+T淋巴细胞水平、治疗依从性等级及抗病毒治疗期间合并应用抗结核药物的比例经统计学分析,差异有统计学意义。结论怀化市接受艾滋病抗病毒治疗患者总体疗效显著,少数患者出现耐药,其耐药与治疗前CD4^+T淋巴细胞水平、治疗依从性及抗病毒治疗期间合并应用抗结核药物存在相关性。Objective To investigate the therapeutic effect and drug resistance of HIV/AIDS patients with highly active anti-retroviral therapy(HAART)in Huaihua city,and to analyze the related factors affecting drug resistance.Methods CD4^+T-lymphocyte and viral load were detected in 367 HIV/AIDS patients treated with antiviral therapy for more than one year in the AIDS clinic and wards of the First People’s Hospital of Huaihua City and aged above 18 years.We performed HIV drug resistant genotype test in the samples with viral load greater than 1,000 copies/ml,and further statistically analyzed the level of CD4^+T-lymphocyte before the treatment,the grade of treatment compliance and the proportion of using anti-tuberculosis drugs during HAART treatment based on grouping.Results Among the patients in the study,86.65%used first-line therapy,92.37%achieved virological inhibition,7.63%had virological failure and 13.89%had CD4^+T-lymphocyte less than 200 cells/μl.18 patients developed drug resistance,and the incidence rate of drug resistance was 4.90%.There were statistically significant differences in the level of CD4^+T-lymphocyte before the treatment,the grade of treatment compliance and the proportion of using anti-tuberculosis drugs during HAART treatment between the drug-resistant group and the non-drug-resistant control group.Conclusions The overall curative efficacy of patients receiving anti-retroviral therapy in Huaihua city was remarkable.A few patients developed drug resistance,and there was a correlation between their drug resistance and the level of CD4^+T-lymphocyte before the treatment,the grade of treatment compliance,using anti-tuberculosis drugs during HAART treatment.

关 键 词：艾滋病 抗病毒治疗 耐药 影响因素 

分 类 号：R512.91[医药卫生—内科学]