55例AIDS病人8年HAART疗效分析

Effect analysis of 8 years of highly active antiretroviral therapy in 55 patients with acquired immune deficiency syndrome

目的评价长期高效抗反转录病毒治疗(HAART)对艾滋病(AIDS)病人的免疫学、病毒学、机会性感染及死亡情况等的影响。方法对2005年1-12月底,在昆明市第三人民医院陆续入组行抗病毒治疗的病人,持续观察8年,按照国家规定进行随访,观察基线及每年的CD+4T淋巴细胞计数均值、病毒载量、耐药情况、死亡情况、机会性感染发生情况等。结果共调查55例病人,9人在治疗过程中转诊至其他治疗点继续治疗,6人停药,1人失访,3人死亡,其余36人坚持治疗8年至今。36人中2人发生耐药,其余病人免疫功能及临床情况较前明显好转,病毒载量均抑制在检测线以下。36例病人在治疗过程中从未出现过机会性感染。结论 HAART可以显著改善病人的免疫功能,避免机会性感染,降低死亡率。长期坚持治疗和良好的依从性是减少耐药、保证病人治疗有效和长期存活的重要因素。

Objective To evaluate treatment effect of highly active antiretroviral therapy （HAART） on immunology, virology, opportunistic infections, death and other aspects in acquired immune deficiency syndrome （AIDS） patients. Methods Patients initially received ART at our hospital from Jan. 2005 to Dec. 2005 were followed up for 8 years. Standard follow-up service were provided according to the national requirements. CD~ counts, Viral load （VL）, drug resistance, death and opportunistic infections（OI） were observed at baseline and every year. Results Among the total 55 cases investigated, 9 were transferred to other clinics, 6 were withdrawed, 1 dropped off, 3 died, and 36 patients had been keeping on treatment up to now. Of the 36 patients, 2 developed drug resistance but the others significantly improved their immune function and clinical status with undetectable VL and never sufferred from OI as well. Conclusion HAART can improve patients immunity, prevent OIs, and decrease mortality rate. Long-term treatment and good adherence are important factors to decrease drug resistance and ensure effective treat- ment and long-term survival.