HIV/AIDS患者抗病毒治疗效果评估及基因型耐药分析

Evaluation of the effect of antiviral therapy and analysis of genotype drug resistance in HIV/AIDS patients

目的对人类免疫缺陷病毒(HIV)携带者和艾滋病(AIDS)患者(简称HIV/AIDS患者)抗病毒治疗效果进行评估并分析其基因型耐药情况。方法选取2018年6月至2020年6月无锡市第二人民医院收治的81例HIV/AIDS患者作为研究对象。对所有患者进行抗病毒治疗,测定CD4+T淋巴细胞计数与病毒载量,分析抗病毒失败患者基因型耐药情况。结果81例HIV/AIDS患者中95.06%患者服药依从性较好,92.59%患者临床症状明显减轻,坚持服药患者中97.40%患者病情好转,未坚持服药患者无病情好转现象,差异具有统计学意义(P<0.05)。81例HIV/AIDS患者最近一次CD4+T淋巴细胞计数高于开始治疗前CD4+T淋巴细胞计数(P<0.05),治疗后免疫学成功率达到85.19%,HIV病毒抑制率达到92.59%。抗病毒失败患者核苷类反转录酶抑制剂(NRTI)、非核苷类反转录酶抑制剂(NNRTI)耐药突变率分别为40.00%、80.00%,其中1例(20.00%)患者出现NNRTI、NRTI双重耐药,主要以3TC/FTC/EFV耐药为主。结论HIV/AIDS患者抗病毒治疗效果明显,但需要患者保持良好服药依从性,治疗失败患者耐药率较高,建议临床加大病毒载量及基因型耐药分析,及时调整治疗方案。

Objective To evaluate the effect of antiretroviral treatment for patients with HIV/AIDS and analyze genotype resistance.Methods 81 HIV/AIDS patients admitted to Wuxi Second People's Hospital from June 2018 to June 2020 were selected as the research subjects.All patients were treated with antiviral therapy,CD4+T lymphocyte count and viral load were measured,and the genotype drug resistance of patients with antiviral failure was analyzed.Results Among the 81 HIV/AIDS patients,95.06%of the patients had better medication compliance,92.59%of the patients had significantly reduced clinical symptoms.97.40%of the patients who persisted in taking the medication improved,and the patients who did not adhere to the medication showed no improvement,the difference was statistically significant(P<0.05).The most recent CD4+T lymphocyte count of 81 HIV/AIDS patients was higher than the CD4+T lymphocyte count before the start of treatment(P<0.05).After treatment,the immunological success rate reached 85.19%,and the HIV virus suppression rate reached 92.59%.Nucleoside reverse transcriptase inhibitors(NRTI)and non-nucleoside reverse transcriptase inhibitors(NNRTI)resistant mutation rates in patients with antiviral failure were 40.00%and 80.00%,respectively,of which 1 case(20.00%)appeared NNRTI and NRTI are dual resistant,mainly 3TC/FTC/EFV resistant.Conclusions The antiviral treatment on HIV/AIDS patients is effective,but patients need to maintain good medication compliance,and the drug resistance rate of patients with treatment failure is relatively high.It is recommended to increase the viral load and genotype drug resistance analysis clinically,and adjust the treatment plan in time.