艾滋病抗病毒治疗后CD4^+T细胞数长期较低的原因分析

Analysis of causes in patients whose CD4^+ T cell count was still low after long-term HAART

目的:探讨临床获得性免疫缺陷综合征(AIDS)患者在高效抗逆转录病毒治疗(HAART)后CD4+T细胞计数长期处于较低水平的原因。方法:选取22例门诊治疗随访1年以上且CD4+T细胞一直低于200个/μL的患者,在知情同意的前提下,取血进行病毒载量和耐药检测,结合患者临床治疗的资料进行原因分析。结果:上海地区经HAART后CD4+T细胞数值仍持续低于200个/μL的AIDS患者,可能受耐药、依从性差、年龄偏大及抗病毒药物具有的骨髓抑制不良反应等因素的影响。结论:临床AIDS患者中,若有在病毒载量控制良好的情况下CD4+T细胞长期较低者,需结其合个人情况调整治疗方案,以提高临床疗效。

Objective To investigate the causes in AIDS patients whose CD4＋ T cell count was still low after longterm HAART （highly active antiretroviral therapy）. Methods Patients who have been making regular follow up in AIDS clinic of Shanghai Public Health Clinical Center for more than one year and with CD4＋ T cell count still lower than 200/μL after long-term HAART were enrolled. After obtaining informed consent, blood samples were collected and viral load and drug resistance were tested. Results of testing were analyzed in coordination with clinical data. Results Drug resistance, poor adherence, old age, the antiviral drug side effects such as bone marrow suppression were the facilitating causation factors. Conclusions For AIDS patients who have CD4＋T cell count still lower than 200μ/L after long-term HAART, physicians should modulate the therapeutic regimen in accordance with patient＇s individualized condition.