25例艾滋病儿童患者临床特征及治疗现状分析  

Clinical characteristics and treatment outcomes of 25 children with AIDS

作　　者：漆维炜 何坤[1] 白艳[1] 罗杨 赵华芳 饶雪 QI Weiwei;HE Kun;BAI Yan;LUO Yang;ZHAO Huafang;RAO Xue(Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心感染科,重庆400036

出　　处：《中国感染与化疗杂志》2023年第4期439-442,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解儿童艾滋病临床特征、抗病毒治疗及生存状态情况。方法回顾收集重庆市公共卫生医疗救治中心在治儿童艾滋病25例患者临床资料。结果25例患儿,男17例,女8例;人类免疫缺陷病毒(HIV)感染确诊时平均年龄(4.2±3.6)岁;22例患儿为母婴传播;1岁以内确诊HIV感染患儿占20%;确证HIV感染后达到快速启动抗病毒治疗患儿占52%。抗病毒治疗方案有10例(40%)患儿使用齐多夫定+拉米夫定+洛匹那韦/利托那韦;按时服药并进行随访的患儿有20例;治疗过程中有3例患儿发生了耐药。随访12个月时检测的患儿中74%(14/19)HIV RNA低于检测线;24个月时有88%(15/17)患儿HIV病毒载量低于检测线。抗病毒治疗后CD4+T淋巴细胞有所增长,与基线数值相比,差异有统计学意义(P<0.05)。结论母婴传播是HIV感染患儿的主要感染途径,孕期全面检测、及时确诊HIV感染及快速启动抗病毒治疗是阻断母婴传播的重要环节,对于已确诊患儿,正确服用抗病毒治疗药物有助于免疫功能恢复。Objective To understand the clinical characteristics,antiretroviral therapy(ART),and survival status of children with AIDS.Methods The clinical data of 25 children with AIDS in Chongqing Public Health Medical Center were collected and reviewed retrospectively.Results The 25 children included 17 males and 8 females.Their mean age at the time of HIV diagnosis was 4.2±3.6 years.Mother-to-child transmission was identified in 22 cases.HIV infection was diagnosed within 1 year old in 20%of the patients.ART was initiated rapidly in 52%of the children after HIV infection was confirmed.Overall,40%of the children received zidovudine(AZT),lamivudine(3TC),and lopinavir/ritonavir(LPV/r)as ART.Twenty of the 25 children complied with the ART regimen and follow-up schedule.Three patients developed drug resistance during ART.The HIV RNA was undetectable in 74%(14/19)of the children at 12-month follow-up,and in 88%(15/17)of the children at 24-month follow-up.After ART,the CD4+T lymphocytes increased significantly compared with the baseline value(P<0.05).Conclusions Mother-to-child transmission is the main route of HIV infection in children.Comprehensive evaluation,timely diagnosis of HIV infection,and rapid initiation of ART during pregnancy are important measures to block mother-to-child transmission.For the children confirmed with HIV/AIDS,appropriate ART may help to restore their immune function.

关 键 词：儿童 艾滋病 临床特征 抗反转录病毒 

分 类 号：R512.91[医药卫生—内科学]