德宏州缅甸籍艾滋病病毒感染者抗病毒治疗效果及影响因素分析

Antiretroviral therapy for Burmese HIV / AIDS infected patients in Dehong Prefecture:Analysis on its curative effect and impact factors

目的评价云南省德宏傣族景颇族自治州(德宏州)境内16岁以上缅甸籍艾滋病病毒感染者接受国家免费高效抗逆转录病毒治疗(HAART)的疗效及影响因素。方法评估患者的病毒学及免疫学应答效果,应用卡方检验或F检验作统计学分析,应用非条件logistic回归分析病毒学应答效果的相关影响因素。结果 523例患者的平均年龄为(35.7±8.5)岁,男性占27.3%,女性占72.7%,基线CD_4^+T淋巴细胞计数平均为(338.2±230.4)个/mm3,治疗后CD_4^+T淋巴细胞计数平均为(525.0±283.3)个/mm3,平均增长186.8个/mm3。对各组治疗前后CD_4^+T淋巴细胞计数的差值进行比较,不同性别、治疗时间、感染途径、基线CD_4^+T淋巴细胞计数者间差异均有统计学意义(P<0.05),男性、静脉注射感染、CD_4^+T淋巴细胞计数>350个/mm3的患者治疗后CD_4^+T淋巴细胞计数增长缓慢,随着治疗时间的延长CD_4^+T淋巴细胞计数的增长逐渐增加。抗病毒治疗后进行病毒载量检测的441例患者中,病毒载量完全抑制的比例为81.0%。经非条件logistic回归分析,性别、年龄、婚姻状况、基线CD_4^+T淋巴细胞水平、治疗时间等因素均与抗病毒治疗后病毒学应答无关(P>0.05)。结论对德宏州境内缅甸籍艾滋病病毒感染者的抗病毒治疗疗效显著。

Objective To evaluate the effectiveness of free highly active anti-retroviral therapy （HAART） for Burmese adult HIV/AIDS patients in Dehong Prefecture and investigate its curative effect and impact factors. Methods To evaluate the virological and immunological responses to HAART in patients, Chi 7 squared tests or F tests were used for statistical analyses and multivariate logistic regression methods for analysis of related factors of the virological response of HAART. Results Among the 523 patients, 27.3% were male and 72.7% female, the mean age being 35.7 ± 8.5. The mean CD4 ＋ T cell count was（ 338.2 ± 230.4 ）/mm3 at baseline, and after treatment, the mean CD4 ＋ T cell count was（ 525.0 ±283.3）/mm3. For comparison between groups, those males were injected with drugs and the baseline level of CD4 ＋ T lymphocyte became greater than 350 cells/mm3 with slower growth of CD4 ＋ T cell count. An increasing trend was observed in the growth of CD4 ＋ T cell count with the increase of treatment time （ P 〈0.05）. After the treatment, 441 cases received viral ioad test, and 81.0% of their results were below the detection limit. Data from the multiple logistic regression analysis indicated that gender, age, marital status, the baseline level of CD4＋ T lymphocyte, treatment time and other factors did not affect the virological response of the HAART. Conclusion Both virological and immunological responses to HAART were well achieved and sustainable for HIV/AIDS patients in Dehong Prefecture. HAART proved to be fairly effective in Dehong Prefecture.