儿童艾滋病高效抗逆转录病毒治疗(HAART)效果观察

Effects of Highly Active Antiretroviral Therapy for Children infected with AIDS

目的 管理和观察儿童艾滋病抗病毒治疗过程，为儿童艾滋病规范治疗和管理提供依据。方法 对符合条件的儿童艾滋病病人提供高效抗逆转录病毒治疗（HAART）并定期进行临床随访观察和相关实验室检测。结果 40例儿童艾滋病病人HAART治疗9个月之前的依从性均能达到95％。儿童的生长发育指标一身高、体重在抗病毒治疗第6个月时均大于第3个月时（P〈0．05）；3个月和6个月时均大于基线时（P〈0．05）。临床症状除持续或间断1个月发热（治疗6个月时）发生5例（17．9％），其他症状发生率均小于10％；除艾滋病脑病1例（5％）以外，没有发生新的严重机会性感染。免疫学指标-CD4^＋T淋巴细胞计数由基线均值103．73±103．89个／μl上升到治疗12个月时的536．60±344．63个／μl（F=8．137，P〈0．05）；平均每治疗3个月CD4T淋巴细胞计数上升约100左右。病毒学指标-病毒载量水平在治疗6个月以上时，病毒复制抑制（VL〈10000 Copies／m1）达到50％-80％。结论 我省儿童抗病毒治疗具有良好的依从性，治疗效果明显，反映在儿童生长发育指标、临床指标、免疫学指标、病毒学指标等方面。

Objective To identify and analyze treatment effect of the highly active antiretroviral therapy （HARRT） for children through following - up AIDS children observation so as to provide evidence for standardized treatment and management of AIDS children. Methods Needed AIDS children were provided HAART therapy with regular clinical and laboratory follow - ups. Results Among the 40 AIDS children with HAART in Anhui province, the rate of medical compliance was more than 95% during the first 9 months. Child growth indicators - height and weight were better at the 6^th month than the 3^rd month after HAART （ P 〈 0.05 ） ; both were better at the 3^rd and 6^th month than the baseline （ P 〈 0.05 ）. There were 5 cases （ 17.9% ） with persistent and intermittent fever at 6th month and the rates of having other symptoms and signs were all less than 10%. There was 1 case of cerebropathia （5%） and there were no other serious opportunistic infections. CD4 lymphocyte count increased from 103.73 103.89pc/ul at baseline to 536.60 344.63 pc/ul at the 12^th month （ F = 8. 137, P 〈 0.05 ）. CD4 count increased about 100 every 3 months of HAART. The rate of HIV virus load suppressed （ VL 〈 10 000 Copies/ml） was 50% ～ 80% after 6 months treatment. Conclusion The medical compliance rate was high among AIDS children with HAART in Anhui and the treatment effectiveness was obvious in terms of child growth , clinical, immunological and virological indicators.