人获得性免疫缺陷病抗病毒治疗参加时机与1年疗效分析

HIV HAART Timing and one-Year Treatment Effectiveness

目的分析自贡市HIV抗病毒治疗参加时机与1年期治疗效果之间的关系,为寻找符合我国国情的参加抗病毒最佳时机提供参考。方法选择自贡市截止2012-09以来所有参加抗病毒治疗的HIV感染者的治疗信息进行分析。结果参加治疗时CD4计数≤100个/mm3的感染者在1年内死亡率为29.8%（14/47）,高于参加治疗时CD4计数〉100个/mm3的感染者（死亡率2.3%,3/133,RR=13,95%CI=3.9~43.3）。参加治疗时出现艾滋病相关症状的感染者在一年死亡率为16%（15/94）,高于未出现症状的感染者（死亡率5.1%,7/138,RR=3.1,95%CI=1.3~7.4）。参加治疗时CD4计数≤200个/mm3的感染者在1年后CD4值平均上升166.7个,高于参加治疗时CD4计数〉200个/mm3的感染者（上升89.2个,t=2.4,P〈0.01）。结论在CD4计数〈200个/mm3或出现艾滋病相关症状时再开始治疗将明显增加感染者1年内死亡率,应努力让感染者在出现这一情况之前接受治疗。

Objective To clarify the relationship between HIV HAART timing and one-year effectiveness among PLHIVs（person living with HIV）,and thus to provide suggestion for optimizing ART beginning time.Methods Basic and follow-up data of PLHIVs who received HAART before September 2012in Zigong city were collected and statistically analyzed.Results The one-year mortality rate of PLHIVs who began HAART with CD4count≤100/mm3 was 29.8%（14/47）,higher than those with CD4count＆gt;100/mm3（mortality rate 2.3%,3/133,RR=13,95%CI=3.9-43.3）.The oneyear mortality rate of PLHIVs who began HAART with AIDS related symptoms was 16%（15/94）,higher than asymptomatic PLHIVs（mortality rate 5.1%,7/138,RR=3.1,95%CI=1.3-7.4）.The Average CD4count raised 166.7among PLHIVs who began ART when CD4count≤200/mm3,higher than those with CD4count＆gt;200/mm3（t=2.4,P＆lt;0.01）.Conclusion Patients with CD4 count≤200/mm3or developed AIDS related symptoms are likely to have a more mortality when taking HAART;thus,it is important to make sure PLHIVs to receive HAART in time.