62例静脉吸毒艾滋病病人抗病毒治疗疗效观察

Effectiveness of highly active antiretroviral therapy in 62 injection drug users

目的通过对62名静脉吸毒艾滋病病人的高效抗逆转录病毒治疗(HAART)队列为期1年的观察,了解在治疗不同时间队列的变化情况、免疫学和病毒学指标的变化趋势及治疗效果。方法2006年6月20日-2007年1月25日期间,纳入了62名初次参加HAART的静脉吸毒艾滋病人,分别在其治疗前、治疗1、6和12个月进行问卷调查和实验室检测。结果在12个月的随访过程中,共有24人(38.7%)因各种原因退出治疗队列。在坚持治疗的患者中,免疫学成功的患者在治疗不同时间CD4+T淋巴细胞增长在统计学上有明显差异,治疗失败者只在治疗12个月有增长。与基线相比治疗不同时间的病毒载量呈现不断下降趋势,治疗6个月和12个月,分别下降了2.51g拷贝/ml和2.61g拷贝/ml。结论吸毒人群抗病毒治疗随访队列的终止治疗率较高,抗病毒治疗的免疫学疗效较差,患者自报的服药依从性与疗效不符,结果有偏移。

Objective To determine the effectiveness of highly active antiretroviral therapy（HAART） by tracing 62 injection drug users （IDUs） as HAART receivers and observing their changing trends of immunological and virological indicatiors in different stages of treatment. Methods Eligible subjects who were naive IDUs and received HAART from June 20,2006 to January 25,2007 were selected. Questionnaire and laboratory tests were administered to these 62 selected cases before the treatment and after the treatment for 1,6 and 12 months. Results In the course of 12 months follow-up, 24（38.7 % ） cases dropped out for various reasons. Those who persisted in HAART and achieved immunologic success displayed statistically significant increases in CD4 ^＋ T lymphocyte cell counts. Patients with immunologic failure showed no increase in CD4 ^＋ count during the first 6 months,but did show such increase during the 12 month period. Compared with the baseline data,patients＇ viral loads were decreasing progressively at different periods of follow-up, dropping by 2.51g copies/ml and 2.61g copies/ml after 6 and 12 months treatment,respectively. Conclusion In the IDU cohort,the rate of HAART termination was high, but the immunological effectiveness of treatment was relatively poor. High self-reported adherence was not consistent with observed effectiveness of HAART.