高基线CD4^+T淋巴细胞计数的HIV感染者抗病毒治疗状况

Analysis of ART current status among HIV infected patients with high baseline CD4 counts

近几年,国内外治疗作为预防（TasP）研究表明,抗病毒治疗（ART）早治组与晚治组相比,可以起到预防艾滋病病毒（HIV）传播的作用,但也有研究显示早治组相比于晚治组对HIV阴性人群没有保护效果。2012年,世界卫生组织将全球抗反转录病毒治疗方案修改为,对于异性感染途径感染HIV的人群,不管其CD4~＋T淋巴细胞（简称CD4细胞）计数,发现即治疗。2016年中国国家卫计委提出,对于所有HIV感染者均建议实施免费抗病毒治疗。因此目前很多高基线CD4细胞计数的HIV感染者能够接受免费ART。然而由于这部分HIV阳性者免疫功能尚未低下,机会性感染、机会性肿瘤等艾滋病（AIDS）并发症发生率低,导致他们服药依从性差,出现HIV抑制失败率高,从而更容易出现耐药。文章将从几个方面对于高基线CD4细胞计数的HIV阳性者ART状况进行阐述。

Recently,supporters of rapid rollout of＂treatment as prevention（TasP）＂strategies debate that it is obvious that the effect of highly active antiretroviral therapy（HAART）access is consistent with decreases in observed sexual transmission of HIV.However,others hold the opposite opinions.In 2012,WHO updated the antiretroviral therapy guidelines,indicating that each HIV infected individual could access HAART,regardless of his/her CD4~＋T cell counts.In 2016,Chinese government adjusted the antiretroviral therapy standards in accordance with those of WHO.Therefore,more HIV infection patients,including those with high CD4 counts,have chances to receive ART.However,because of their high level of immunity,less chances of opportunistic infection and malignancy,they have poor compliance in HAART,which could result in virological suppression and drug resistance.This review summarizes the current status of ART among HIV infected patients with high baseline CD4 counts.