两种高效抗反转录病毒方案预防艾滋病母婴传播的效果

Effects of two kinds of high efficient antiretroviral therap for prevention of mother-to-fetus transmission of HIV

目的:了解两种高效抗反转录病毒(HAART)方案预防艾滋病母婴传播的效果,为进一步合理选择母婴阻断抗病毒治疗方案提供依据。方法:采用两种方案(齐多夫啶AZT+拉米夫啶3TC+克力芝LPV/r和齐多夫啶AZT+拉米夫啶3TC+施多宁/奈韦拉平EFV/NVP)预防艾滋病母婴传播,对入组病例在服药前、孕36周及产后3个月进行CD4+T淋巴细胞计数和血浆HIV病毒载量测定。结果:共入组72例孕产妇,所生73例婴儿除1例因新生儿窒息死亡外,其余72例经早期HIVDNA-PCR核酸检测,结果均为阴性;血浆病毒载量在孕36周时最低(P<0.001);CD4+T淋巴细胞水平从治疗前至产后3个月呈增高趋势(P<0.001);治疗前后的病毒载量及CD4+T淋巴细胞平均水平两组间均无统计学差异(P>0.05)。结论:两种HAART方案预防艾滋病母婴传播效果显著,在病毒抑制和提高CD4+T淋巴细胞计数上两方案效果一致。

Objective： To understand the effects of two kinds of high efficient antiretroviral therapies （HAART） for preventing mother - to - fetus transmission of HIV, provide a basis for further choosing therapeutic regimens for block of mother - to - fetus transmission of HIV reasonably. Methods： Two regimens （ AZT plus 3TC plus LPV/r and AZT plus 3TC plus EFV/NVP） were adopted to prevent mother - to - fetus transmission of HIV, the number of CD4 ＋ T lymphocytes and plasma HIV load were detected before treatment, on the 36th gestational weeks, and at three months after delivery. Results： Seventy - two pregnant women were enrolled into the study. A total of 73 infants were born, and expect one dead baby because of neonatal asphyxia, the other seventy - two infants were found with negative HIV DNA by early HIV DNAPCR nucleic acid test; the plasma HIV load was the lowest on the 36th gestational weeks （P 〈0. 001 ） . From before treatment to three months after delivery, the level of CD4 ＋ T lymphocytes showed an increasing trend （P 〈0. 001 ） . There was no statistically significant difference in HIV load and mean level of CD4 ＋T lymphocytes before and after treatment between the two groups （P 〉 0. 05） . Conclusion ： The effects of the two HAART regimens for preventing mother - to - fetus transmission of HIV are significant, at aspects of inhibiting HIV and improving the number of CD4 ＋T lymphocytes, the effects of two regimens are similar.