血友病合并HIV/HCV感染者52例高效抗反转录病毒疗效分析

Efficacy analysis of HAART in 52 cases of hemophilia with HIV/HCV coinfection

目的探讨血友病合并人免疫缺陷病毒（HIV）／丙型肝炎病毒（HCV）感染者高效抗反转录病毒治疗（HAART）方案[司他夫定（d4T）＋拉米夫定（3TC）＋依非韦仑（EFV）]的疗效。方法观察52例合并HIV／HCV感染的血友病患者在接受“d4T＋3TC＋EFV”抗HIV治疗后CD4T淋巴细胞计数、HIV RNA载量的变化情况及药物的不良反应。结果抗HIV治疗后，CD4T淋巴细胞计数均有不同程度的升高，平均每月增长（7．70±4．80）个／mm^3,HIV RNA载量显示不同程度下降，50例患者的HIV RNA载量在治疗后2～7个月均低于检测水平；29例患者出现三酰甘油升高，22例出现血尿酸升高。结论“d4T＋3TC＋EFV”方案是合并HIV／HCV感染的血友病患者安全、有效的HAART方案。

Objective To investigate the efficacy and safety of initial antiretroviral regimen lamivudine ＋ efavirenz ＋ stavudine for hemophiliacs co-infected with HIV/HCV. Methods The changes in CD4 T lymphocyte counts and HIV RNA loads were tested in the course of treatment. The side effects of antiviral agents were also monitored. Results The CD4 T lymphocyte counts increased variably in the 52 patients. The CD4 T lymphocyte counts increased by （7.70 ± 4.80） cells/mm^3 per month by average. HIV RNA loads decreased variably. HIV RNA load was undetectable （%50 copies/mL） in all the 50 patients after treatment for 2-7 months. The serum triglyceride level elevation was identified in 29 patients. Serum uric acid level increased in 22 patients. Conclusions Lamivudine ＋ efavirenz ＋ stavudine regimen is an effective and safe combination antiretroviral regimen for hemophiliac with HIV/HCV infection.