中山市HIV/AIDS简化二联抗反转录病毒治疗临床研究

Clinical Study of Simplified Antiretroviral Therapy for HIV/AIDS in Zhongshan

目的:探讨中山市人类免疫缺陷病毒(HIV)/艾滋病(AIDS)简化二联抗反转录病毒治疗情况。方法:研究对象选取我院2017年4月至2019年3月间接受标准三联治疗(替诺福韦酯+拉米夫定+洛匹那韦/利托那韦)并取得完全病毒抑制(病毒载量<50copies/mL)的HIV/AIDS患者80例,随机分为简化治疗组(拉米夫定+洛匹那韦/利托那韦,40例)和维持标准治疗组(替诺福韦酯+拉米夫定+洛匹那韦/利托那韦,40例)。比较两组患者抗病毒治疗效果和肌酐清除率情况。结果:两组患者0周、24周、48周的病毒完全抑制率、CD4计数水平,均无明显差异(P>0.05);两组治疗48周的CD4^(+)T淋巴细胞计数均明显高于治疗前(P<0.05)。不含替诺福韦酯的简化治疗组患者转换治疗48周的肌酐清除率略高于转换治疗前,含替诺福韦酯维持标准治疗组肌酐48周的清除率低于0周水平。结论:拉米夫定+洛匹那韦/利托那韦简化二联抗反转录病毒治疗HIV/AIDS的临床效果不劣于标准三联疗法;不含替诺福韦酯的简化治疗方案,其更具肾脏安全性。

Objective:To explore the situation of simplified retrovirus therapy for human immunodeficiency virus(HIVAIDS)in Zhongshan.Methods:A total of 80 patients with HIVAIDS who received standard triple therapy(tenofovir+Lamivudine+Lopinavir)from April 2017 to March 2019 and achieved complete viral inhibition(viral load&Lt;50 COPIES/ML)were selected,the patients were randomly divided into the simplified treatment group(Lamivudine+Lopinavir/ritonavir,40 cases)and the Maintenance Standard Treatment Group(Tenofovir+Lamivudine+Lopinavir,40 cases).The effect of antiviral therapy and creatinine clearance rate were compared between the two groups.Results:There was no significant difference in the complete inhibition rate and CD4 count between the two groups at 0,24 and 48 weeks(P>0.05),and the CD4^(+)T lymphocyte count of the two groups at 48 weeks was significantly higher than that before Treatment(P<0.05).The creatinine clearance of the simplified treatment group without Tenofovir dipivoxil was slightly higher than that of the pre-conversion Treatment Group at 48 weeks,and the creatinine clearance of the standard treatment group with Tenofovir dipivoxil was lower than that at 0 weeks.Conclusion:The clinical efficacy of Lamivudine plus Lopinavir Ritonavir in the treatment of HIVAIDS is not inferior to that of the standard retrovirus,and the simplified regimen without Tenofovir dipivoxil is safer in the kidney.