柳州市艾滋病高效抗反转录病毒治疗3年的效果评估

A 3-year study on efficacy of highly active antiretroviral therapy in AIDS patients

目的探讨艾滋病高效抗反转录病毒治疗(HAART)3年的效果。方法回顾性分析150例病人36个月的基线和随访资料,统计分析病人抗病毒治疗3年的免疫重建情况。结果基线CD+4T淋巴细胞(简称CD4细胞)数≥200个/μL的病人,治疗3年后全部发生免疫重建。100个/μL≤CD4细胞数<200个/μL的病人,治疗第1年CD4细胞数平均增长167个/μL,高于第2年增长数(增长80个/μL)(t=2.941,P<0.05)。CD4细胞数<50个/μL的病人,治疗2年较1年免疫重建率高(χ2=12.056,P<0.05);治疗3年较2年免疫重建率高(χ2=11.867,P<0.05)。50个/μL≤CD4细胞数<100个/μL的病人,治疗1年与2年、2年与3年免疫重建率的比较,以及治疗第1年与第2年CD4细胞增长数的比较,差异均无统计学意义。结论病人经HAART后,大部分病人可发生免疫重建,但50个/μL≤基线CD4细胞数<200个/μL的病人,治疗1年如未发生免疫重建,建议更换含蛋白酶抑制剂方案治疗。

Objective To explore the efficacy of highly active antiretroviral therapy（HAART）in AIDS patients.Methods The baseline and follow-up data of 150 cases of AIDS patients were included for retrospective analysis.The survey lasted for 36 months.Immune reconstitution profiles were analyzed in AIDS patients receiving 3years＇ antiretroviral therapy.Result Immune reconstitution was found among all of 27 patients who began HAART with baseline CD＋4T counts≥200/μL.The average CD＋4T counts raised 167 in the first year among AIDS patients receiving antiretroviral therapy with 100/μL≤ baseline CD＋4T counts200/μL,higher than in the second year（t=2.941,P0.05）.With baseline CD＋4T counts50/μL,the rate of immune reconstitution of patients receiving 2years＇ antiretroviral therapy was higher than receiving 1year＇s antiretroviral therapy（χ^2=12.056,P〈0.05）;the rate of immune reconstitution of patients receiving 3years＇ antiretroviral therapy was higher than receiving 2years＇ antiretroviral therapy（χ^2=11.867,P〈0.05）.With 50/μL≤baseline CD＋4T counts100/μL,there was no significant difference in the rate of immune reconstitution between receiving 2years＇ antiretroviral therapy and receiving 1year＇s antiretroviral therapy;there was also no significant difference in the rate of immune reconstitution between receiving 2years＇ antiretroviral therapy and receiving 3years＇ antiretroviral therapy;statistical results suggested that the raising CD＋4T counts was similar every year in those patients.Conclusion The study demonstrated antiretroviral therapy with nucleoside reverse transcriptase inhibitor（NRTI）and non-nucleoside reverse transcriptase inhibitor（NNRTI）regimens might increase CD＋4T cell counts in a majority of subjects.After receiving 12 months＇ antiretroviral therapy,the patients with suboptimal immune reconstitution and 50/μL≤baseline CD＋4T count200/μL might switch to second-line generic protease inhibitor containing HAART.