晋江市艾滋病患者抗病毒治疗效果评价

Evaluation of highly active antiretroviral therapy effect of HIV/AIDS in Jinjiang

目的艾滋病抗病毒治疗可以有效抑制病毒的复制,使人体被破坏的免疫功能逐步恢复,从而延缓病程进展,延长患者生命时间,提高生活质量。本研究旨在了解晋江市艾滋病患者抗病毒治疗现状,评价治疗效果。方法资料来源于泉州市疾病预防控制中心和晋江市医院以及艾滋病防治基本信息系统,从2005-06-01-2017-12-31晋江市陆续有530例艾滋病患者开始抗病毒治疗,按治疗开始日期分成4组,调查随访日期至2018-12-31。随访期间监测CD4^+T淋巴细胞和病毒载量等变化情况,将各组2018年CD4^+T淋巴细胞计数与治疗前基线CD4^+T淋巴细胞计数进行比较分析,记录死亡和退出治疗情况。结果晋江市艾滋病患者接受抗病毒治疗最长时间>13年,最短治疗6d,随访过程中死亡43例,退出治疗36例。变更治疗方案124例,主要原因为不良反应104例,占比83.9%。2005-2009年新治疗23例,CD4^+T淋巴细胞平均水平由99.96个/μL上升至575.89个/μL,t=8.509,P<0.05;2010-2013年新治疗107例,CD4^+T淋巴细胞平均水平由198.56个/μL上升至496.09个/μL,t=10.532,P<0.05;2014-2015年新治疗151例,CD4^+T淋巴细胞平均水平由258.83个/μL上升至486.57个/μL,t=8.556,P<0.05;2016-2017年新治疗249例,CD4^+T淋巴细胞平均水平由301.85个/μL上升至476.63个/μL,t=7.452,P<0.05;各治疗组2018年CD4^+T淋巴细胞水平比治疗前均有明显上升,差异有统计学意义。2016-2018年病毒抑制率分别为80.70%、68.67%和58.51%。1、3、5和9年生存率为别为91.89%、89.32%、87.69%和86.96%。结论晋江市艾滋病患者抗病毒治疗效果良好。

OBJECTIVE Anti viral treatment of AIDS can effectively inhibit the replication of the virus,gradually restore the damaged immune function of the human body,thus delaying the progress of the disease,prolonging the life time of patients and improving the quality of life.This paper aims to understand the status of highly active antiretroviral therapy(HARRT)of HIV/AIDS patients in Jinjiang City,and evaluate the effect of HARRT.METHODS The data collected from the treatment unit Quanzhou Center for Disease Control and Prevention,Jinjiang Hospital and the basic information system of HIV/AIDS prevention and control.From June 1,2005 to December 31,2017,530 HIV/AIDS started HAART in Jinjiang City and were divided into four groups by initial date of treatment.The follow-up date was up to December 31 of 2018.During the follow-up period,the changes of CD4^+T lymphocyte and viral load were monitored.The CD4^+T lymphocyte count of each group in 2018 was compared with the baseline CD4^+T lymphocyte count before treatment.The death and withdrawal of treatment were recorded.RESULTS The longest time of HARRT was more than13 years and the shortest time was 6 days.43 patients died and 36 patients quited.The main reason of changed treatment plan of 124 cases was side effect,accounting for 83.9% by 104 cases.Group started from 2005 to 2009,the average level of CD4^+T lymphocyte increased from 99.96/μl to 575.89/μl,t=8.509,P<0.05.For the group started from 2010 to2013,the average level of CD4^+T lymphocyte increased from 198.56/μl to 496.09/μl,t=10.532,P<0.05.For the group started from 2014 to 2015,the average level of CD4^+T lymphocyte increased from 258.83/μl to 486.57/μl,t=8.556,P<0.05.For the group started from 2016 to 2017,the average level of CD4^+T lymphocytes increased from 301.85/μl to476.63/μl,t=7.452,P<0.05.The level of CD4^+T lymphocytes in each group increased significantly in 2018 compared with that before treatment,with a statistically significant difference.From 2016 to 2018,the virus inhibition rates were80.70%,68.67%and 58.51%respectively.The 1-year survival rate was 91.89%,the 3-year survival rate was 89.32%,the 5-year survival rate was 87.69%,and the 9-year survival rate was 86.96%.CONCLUSION The effect of HAART was comparatively good in Jinjiang.