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刘宝贵, 刘静, 李秀金, 王亚男, 张子宁, 刁莹莹, 代娣, 姜拥军, 尚红. 吉林市HIV/AIDS患者病程及抗病毒效果评价[J]. 中国公共卫生, 2005, 21(11): 1291-1294. DOI: 10.11847/zgggws2005-21-11-07
引用本文: 刘宝贵, 刘静, 李秀金, 王亚男, 张子宁, 刁莹莹, 代娣, 姜拥军, 尚红. 吉林市HIV/AIDS患者病程及抗病毒效果评价[J]. 中国公共卫生, 2005, 21(11): 1291-1294. DOI: 10.11847/zgggws2005-21-11-07
LIU Baogui, LIU Jing, LI Xiujin, . Study on disease progression and efficacy of highly active antiretroviral therapy in HIV/AIDS patients in Jilin city[J]. Chinese Journal of Public Health, 2005, 21(11): 1291-1294. DOI: 10.11847/zgggws2005-21-11-07
Citation: LIU Baogui, LIU Jing, LI Xiujin, . Study on disease progression and efficacy of highly active antiretroviral therapy in HIV/AIDS patients in Jilin city[J]. Chinese Journal of Public Health, 2005, 21(11): 1291-1294. DOI: 10.11847/zgggws2005-21-11-07

吉林市HIV/AIDS患者病程及抗病毒效果评价

Study on disease progression and efficacy of highly active antiretroviral therapy in HIV/AIDS patients in Jilin city

  • 摘要:
      目的   研究吉林市93例HIV感染者/AIDS病人疾病进展情况; 采用高效抗逆转录病毒治疗(HAART)的疗效, 为HIV/AIDS综合防治措施提供科学依据.
      方法   通过现场流行病学调查分析HIV感染者/AIDS病人一般情况, 检测抗丙型肝炎病毒(HCV)抗体, 定期进行CD4+、CD8+T淋巴细胞绝对计数检测以监测疾病进展, 用HAART治疗HIV感染者/AIDS病人, 监测病毒学及免疫学变化, 观察抗病毒药物的毒副作用及服药依从性.
      结果   吉林市93例HIV感染者/AIDS病人中86例(92.5%)经血液感染且合并HCV感染.估计感染时间在8年以上者88例, 其中20.5%CD4+T淋巴细胞数 < 200/mm3, 50%为200~500/mm3, 29.5% > 500/mm3.接受HAART治疗的23例HIV感染者/AIDS病人治疗前平均病毒载量为5.06 log拷贝/ml(4.39×105拷贝/ml), 治疗12个月后平均下降3.47log拷贝/ml(P < 0.001), 其中16例达到检测不出的水平(< 400拷贝/ml), CD4+T淋巴细胞数平均上升48个/mm3(P < 0.05).
      结论   吉林市存在部分疾病进展缓慢的HIV感染者; HAART治疗取得了较好的疗效, 但司他夫定和去羟肌苷联合应用使周围神经病变发生率较高; 加强对感染者疾病进展和抗病毒疗效及不良反应监测, 有助于确定开始抗病毒治疗的时机和及时调整治疗方案.

     

    Abstract:
      Objective   To evaluate disease pro gression and efficacy of hig hly active antiretroviral therapy(HAART)in 93 HIV/AIDS patients in jinlin city, and to provide scientific basis to work outa guideline for prevention and control of HIV/AIDS in China.
      Methods   93 HIV-seropositive individuals were enrolled in a prospective study.Anti-HCV was detected by ELISA method.Disease progression was determined by detecting CD4+ Tcell counts every three months.Viral load, CD4+ Tcell counts, clinical manifestations, drug related adverse events and adherence were monitored for HIV/AIDS patients receiving HAAER during 52 weeks follow-up.
      Results   In 93 HIV-1 infected individuals, 92.5%(86/93)were HCV antibody positive and infected through illegal donation blood.88 individuals infected HIV over 8 years, the per centage of patients with baseline CD4+ Tcell counts < 200 cells/mm3, 200~500 cells/mm3 were 20.5%, 50%, 29.5% respectively.The mean viral load of 23 HIV/AIDS patients receiving HAARTwas 5.06 log copies/ml(4.39×105copies/ml)atbaseline and decreased 3.47 log copies/ml after 52 weeks treatment(P < 0.001)and the viral load level of 70%(16/23)patients became undetectable(< 400 copies/ml).The mean CD4+ Tcell counts of the 23 patients increased 48 cells/mm3 after 52 week treatment(P < 0.05).
      Conclusion   There are some HIV-1 infected individuals with delayed disease prog ression in Jilin city.HAARTis effective in reducing HIV-RNA and impr oving immune functions at 52 weeks, butthe rate of peripheral neuropathy is high by combining Didanosine(ddI)and Stavudine(d4T).Monitoring clinical pro gression and efficacy HAARTare importantfor antiretroviral therapy initation and regimen adjustment.

     

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