河南省某地区HIV感染者治疗和耐药现况调查

An investigation of treatment of persons infected with HIV and drug resistance in certain areas of Henan province

目的调查了解河南省某地区艾滋病病毒(HIV)感染者的人口学特征、实验室检测指标以及治疗病人服药的依从性和耐药产生情况,为进一步开展抗病毒治疗(ART)和耐药检测提供指导。方法随机调查某地区经免疫印迹试验(WB)确认的HIV感染者,进行统一的问卷调查,同时采血检测CD4+T淋巴细胞计数、病毒载量及耐药性结果。结果共调查该地区HIV感染者411人,男性192人,女性219人;平均年龄42.15岁。被检测者中91.48%为既往有偿献血感染。治疗组病人CD4+T细胞计数>200个/ml的例数占治疗组总例数的86.27%,治疗组中治疗有效(病毒载量<1 000拷贝/ml)的比例(52.75%)高于未治疗组(19.74%)(P<0.000 1);未治疗组和治疗组分别有2例和38例发生高度耐药突变;治疗者中有32人近一个月有漏服药物史,漏服原因主要是遗忘、干农活不在家、副反应等。结论基本明确了调查地区HIV感染者治疗情况以及耐药情况,提示应加强耐药监测和对病人的治疗干预工作。

Objective To understand the demographic characteristic,the results of laboratory examinations and the situation of therapy compliance and drug resistance in persons infected with HIV in certain areas of Henan province and to provide guidance for expanding HAART and surveillance of drug resistance. Methods From certain areas in Henan province,persons infected with HIV were randomly selected,who were confirmed by WB and were investigated by questionnaire. Blood samples were taken, and then the number of CD4^＋ cells were calculated, and virus loads and drug resistance were examined.Results Investigated objects included 411 persons infected with HIV（192 males and 219 females） ,and their mean age was 42.15 years. Of them,91.48 % were infected by former paid blood donation;the CD4^＋ cell calculation 〉 200/ml were detected in 86.27 % of thoses who received ARV therapy. The virus load〈 1 000 copies/ml were detected in 52.75 % of those who received ARV therapy and in 19.74 % of those who failed to do so （P 〈 0. 0001 ）. High rates of drug resistance were detected in 2 subjects who failed to recieve therapy and in 38 subjects who did receive therapy. Thirty two subjects who received therapy did not taken drugs in time in the last one month, because of poor compliance with ther- apy regime, unavailability of drugs while doing farm work or being away from home, or severe side effects so on. Conclusion The situation of therapy and drug resistance in persons infected with HIV in investigated areas became more or less clear after our study, which indicated that the surveillance of drug resistance and therapy should be further strengthened.