816例初始抗病毒治疗免疫学和病毒学疗效分析

The immunological and virological efficacy of 816 HIV-1 infected adults with initial antiretroviral therapy

目的评价我国现行高效联合抗逆转录病毒治疗（HAART）48周在成人初治HIV／AIDS患者中的免疫学和病毒学疗效。方法回顾性研究我院初次接受HAART的HIV／AIDS患者816例．分析治疗前后的免疫学和病毒学疗效。结果816例中男749例（91．8％），女67例（8．2％）；年龄19～70岁。平均（32．0±18．8）岁。传播途径以男男同性性行为（681例，83％）为主。在治疗48周后，CD4细胞均值由223个，m升高至437个／nl，CD4细胞在200个／μl以下者由39．7％降至12．5％，CD4细胞201～350个／μl者由50．2％降至26．2％，CD4细胞〉350个／μl者由10．0％增至61.3％。病毒载量平均值由13490拷贝／ml下降至42拷贝／ml，病毒载量小于50拷贝／ml者占90．9％。结论现行的艾滋病HAART疗效较好，值得推广。

Objective To evaluate immunological and virological efficacy of the China＇s national free highly active antiretroviral therapy （HAART） in 816 treatment-naive HIV/AIDS adults. Methods The study enrolled 816 treat- ment-naive HIV/AIDS patients initiated with antiretroviral treatment （ART） in our hospital. Immunological and virological efficacy was analyzed before and after ART. Results Of the 816 patients, 749 （91.8%） were male and the mean age was 32 years （range, 19 to 70 years）. The main transmission route was unprotected sex among men who have sex with men （681, 83%）. After 48 weeks of ART, the median CD4 cell counts of 816 patients increased from 233 eells/μL to 437 cells/μL. Patients with CD4 cells less than 200 cells/μL dropped from 39.7% 12.5%, those with CD4 cells 201-350 cells/μL dropped from 50.2 % to 26.2%, and those with CD4 cells greater than 350 eetls/μL increased from 10.0% to 61.3%. The median viral load decreased from 13 490 copies/mL to 42 copies/mL and 90.9% patients achieved vi ral load less than 50 eopies/mL at 48 weeks. Conclusion The current China＇s national ART regimens are effective. ART should be actively promoted to improve the health of HIV infected patients.