克力芝为基础的ART方案对偏于晚期HIV/AIDS病人的疗效分析

Efficacy analysis of ART based on Kaletra in drug resistance of HIV/AIDS patients

目的评估基于克力芝（LPV/r）为基础的抗反转录病毒治疗（ART）方案,对治疗起始点偏于晚期的艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人的疗效。方法对来自本院112例治疗起始点偏晚[CD4＋T淋巴细胞（简称CD4细胞）计数〈200个/μL为基准]的病人,在抗病毒治疗24个月后进行疗效分析。结果 112例病人中,基于依非韦伦（EFV）一线方案起始治疗91例,在治疗半年后出现治疗失败49例,其中5例出现严重机会性感染,平均CD4细胞为（92±51）个/μL,与21例基于治疗起始点含克力芝为基础的二线ART方案比较,治疗半年后CD4细胞数差异有统计学意义（P〈0.01）。49例治疗失败后更换基于克力芝为基础的二线方案后治疗成功,24个月后平均CD4细胞为（298±176）个/μL,与21例起始治疗即基于克力芝为基础的ART方案比较,差异无统计学意义（P〉0.05）。结论对于治疗起始点偏于晚期的病人,基于克力芝的起始方案更加安全,有效,不容易出现治疗失败。

Objective To evaluate the efficacy of ART regimens containing Kaletra（LPV/r）in treatment of late stage of HIV/AIDS patients.Methods 112 HIV/AIDS patients in late stage（CD4~＋T cell count less than 200/ul）treated with ARV drug within 24 months were included in this study.Results Out of all 112 HIV/AIDS patients,91 cases were treated with EFV as first-line regimen,and 49 cases failed in the treatment within six months,among them 5 cases got serious opportunistic infections,with the average CD4~＋T counts of 92±51 l/μL,which was significantly different（P〈0.01）,compared with that of the 21 cases initially treated by Kaletra.However,after the 49 cases changed their ART regimens containing Kaletra as the second-line regimen of the treatment,the average of CD4~＋T cells increased to 298~＋176/ul in 24 months and the difference was not significant in CD4~＋T cells counts（P〉0.05）compared with that of the 21 patients who had Kaletra in the initial treatment.Conclusion The ART regimens containing Kaletra in treatment of HIV/AIDS patients in late stage will be more safe and effective.