摘要
目的探讨高效抗反转录病毒治疗(HAART)对艾滋病(AIDS)合并乙肝病毒(HBV)感染者体内乙肝病毒基因(HBV-DNA)的影响。方法选取2016年1月~2017年6月我院收治的AIDS合并HBV感染的30例患者作为研究对象,所有患者给予一线HAART治疗方案,即拉米夫定(3TC)300mg,1次/d,富马酸替诺福韦(TDF)300mg,1次/d,依非韦仑(EFV)600mg,1次/d,疗程为48周,每3个月检测患者的肝功能和乙肝病毒载量。比较患者24、48周时抗HBV-DNA的总有效率;评估肝功能检测结果和不良反应发生情况;比较患者不同CD4+基线值实施HAART后48周免疫重建的总有效率。结果患者HAART48周时的抗HBV-DNA总有效率高于治疗24周时,差异有统计学意义(P<0.05)。20例患者的丙氨酸氨基转移酶(ALT)>40U/L,15例患者的天门冬氨酸氨基转移酶(AST)>50U/L,经药物保肝治疗,肝功能未发生持续损害。29例患者>200cell/μlCD4^+基线值HAART后48周的免疫重建总有效率高于≤200cell/μlCD4^+基线值HAART后48周,差异有统计学意义(P<0.05)。部分患者用药后出现不良反应,对症处理后中途无停药者。结论采用HAART方案能有效控制AIDS并HBV感染者体内的HBV-DNA和促进患者体内的免疫重建,为后续的临床研究提供了依据。
Objective To investigate the effect of high-efficiency antiretroviral therapy(HAART)on hepatitis B virus gene(HBV-DNA)in patients with acquired immune deficiency syndrome(AIDS)complicated with HBV infection.Methods Thirty patients with AIDS complicated with HBV infection admitted to our hospital from January 2016 to June 2017 were selected as the study subjects,all patients were given a first-line HAART regimen,namely Lamivudine(3 TC)300 mg,once a day,Tenofovir Fumarate(TDF)300 mg,once a day,and Efeveren(EFV)600 mg,once a day for48 weeks,the patients′liver function and HBV load were measured every three months.The total effective rate of antiHBV-DNA at 24 and 48 weeks was compared.The results of liver function test and occurrence of adverse reactions were evaluated.The total effective rate of immune reconstitution 48 weeks after HAART with different CD4^+baseline values was compared.Results The total effective rate of anti-HBV-DNA at 48 weeks of HAART was higher than that at 24 weeks of HAART,the difference was significant(P<0.05).Alanine aminotransferase(ALT)>40 U/L in 20 patients and aspartate aminotransferase(AST)>50 U/L in 15 patients,the liver function did not suffer from sustained damage after liver protection treatment.The total effective rate of immune reconstitution in 29 patients with>200 cell/μl CD4^+baseline HAART at 48 weeks was higher than that of≤200 cell/μl CD4^+baseline HAART at 48 weeks,the difference was statistically significant(P<0.05).Some patients had adverse reactions after medication,and there was no discontinuation after symptomatic treatment.Conclusion HAART regimen can effectively control HBV-DNA and promote immune reconstitution in patients with AIDS and HBV infection,which provides a basis for follow-up clinical research.
作者
杨生晟
徐焕新
李艳芳
毛龙火
蔡曼
王萌
YANG Sheng-sheng;XU Huan-xin;LI Yan-fang;MAO Long-huo;CAI Man;WANG Meng(Department of Acute Infectious Disease,Jiujiang Third People's Hospital of Jiangxi Province,Jiujiang 332000,China)
出处
《中国当代医药》
2019年第21期34-36,共3页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20177115)
关键词
高效抗反转录病毒治疗
艾滋病
乙肝病毒感染
乙肝病毒基因
High-efficiency antiretroviral therapy
Acquired immune deficiency syndrome
Hepatitis B virus infection
Hepatitis B virus gene