艾博韦泰方案在重症艾滋病患者中的临床疗效研究

The Clinical Effect of Albuvirtide Program in Severe AIDS Patients

目的观察艾博韦泰(ABT)联合核苷类(2NRTI)和整合酶(INSTI)抗病毒治疗(ART)方案治疗初治重症艾滋病(AIDS)患者30例的近期疗效及不良反应;探讨接受两组不同ABT联合抗病毒治疗方案的患者疗效有无差异。方法收集2019年3月至2019年7月住院并接受ABT联合抗病毒治疗方案治疗6周的初治重症AIDS患者的临床及实验室数据,进行统计学分析;A组为使用ABT+2个核苷类(2NRTI)+整合酶(INSTI)方案治疗的患者18例,B组为ABT+2NRTI方案治疗的患者12例;A组ABT使用方法为320 mg每周1次,B组ABT使用方法为320 mg第1天、2天、3天、8天及以后每周1次。结果共纳入30例患者,男性为主,平均年龄(47.23±15.21)岁,基线HIV RNA(5.33±0.62)Log 10 copies/ml,基线CD456个/μL(14.5~132个/μl),CD8381.5个/μl(223.75~834.75个/μl),CD4/CD80.13(0.05~0.29)。疗效分析显示:ART 2周30例患者检测HIV RNA(2.93±0.88)Log 10 copies/ml,较基线下降(2.41±0.86)Log 10 copies/ml(P<0.01);治疗6周,26例患者检测HIV RNA(2.38±1.05)Log 10 copies/ml,较基线下降(2.97±1.18)Log 10 copies/ml(P<0.01),病毒较基线下降A组优于B组(P<0.05);CD4较基线平均增长(112.63±97.65)个/μl,CD8平均增长(434.90±512.57)个/μl,CD4/CD8平均增长(0.07±0.15)。两组基线水平及治疗后免疫水平的变化差异无统计学意义(P>0.05)。30例患者均未发现有注射位点反应及与ABT直接相关的不良反应。结论初治重症AIDS患者使用ABT联合抗病毒治疗方案可在短期内快速降低HIV RNA水平,改善免疫功能,不良反应少。

Objective To observe and analyze the curative effect and adverse reactions of containing Albuvirtide(ABT)regimen in real world in newly treated patients with severe AIDS,and to explore differences of curative effect about ABT combined with different ART regimens.Methods From March 2019 to July 2019,clinical data of newly treated severe AIDS patients who used containing ABT regimen were collected and statistically analyzed.Using ABT+2 nucleosides(2NRTI)+integrase(INSTI)regimen was group A,using ABT+2NRTI was group B.For ABT,320 mg once a week was used in group A,and 320 mg once a week on the 1st,2nd,3rd,8th and thereafter was used in group B.Results A total of 30 patients were enrolled,mainly male,with an average age of(47.23±15.21)years,baseline HIV RNA of(5.33±0.62)Log10 copies/ml,baseline CD4 of 56/μl(14.5~132/μl),CD8 of 381.5 Pieces/μl(223.75~834.75 pieces/μl),CD4/CD8 of 0.13(0.05~0.29).Efficacy analysis showed that after 2 weeks of treatment,30 cases were tested for HIV RNA(2.93±0.88)Log10 copies/ml,which was lower than baseline(2.41±0.86)Log10 copies/ml(P<0.01).After 6 weeks of treatment,26 cases were tested for HIV RNA(2.38±1.05)Log10 copies/ml,which decreased from baseline(2.97±1.18)Log10 copies/ml(P<0.01).Compared with baseline,CD4 increased by(112.63±97.65)copies/μl,the average increase of CD8 was(434.90±512.57)/μl and CD4/CD8 was(0.07±0.15).ABT was used less frequently in group A than in group B.After treatment,virus control in group A was better than group B(P<0.05).There was no significant difference in the baseline and immune level between two groups after treatment(P>0.05).All 30 patients received more than two kinds of drugs in combination,and there were no injection site reactions and adverse reactions directly related to ABT.Conclusion The use of containing ABT regimens for newly treated severe AIDS patients could quickly reduce HIV RNA in a short period of time and improve immune function with fewer adverse reactions.The intensive regimen with increased integrase could quickly reduce HIV RNA.