人类免疫缺陷病毒感染者抗病毒治疗与疾病进展关系研究

The relationship between antiretroviral therapy and disease progression of HIV infected patients

目的探究人类免疫缺陷病毒(HIV)感染者抗病毒治疗与疾病进展的关系。方法选取2019年1月至2020年1月保定市人民医院收治的215例HIV-1感染患者作为研究对象。检测并比较治疗前后血常规、肝功能指标、生化指标、免疫学指标、HIV-1 RNA载量、临床症状体征积分,分析基因分型和耐药性。结果HIV-1感染患者治疗后谷草转氨酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素(TBil)、白蛋白(ALB)水平高于治疗前(P<0.05);治疗后CD4+T高于治疗前,CD8+T、HIV-1 RNA载量低于治疗前(P<0.05);HIV-1感染患者治疗后各时间段HIV-1转阴率均在90.00%以上,治疗后各时间段临床症状体征积分均低于治疗前(P<0.05);HIV-1感染患者HIV-1亚型分别为A亚型(3.50%)、B亚型(7.50%)、C亚型(31.50%)、B+C亚型(9.50%)、CRF01_AE亚型(36.00%)、CRF07_BC亚型(4.50%)、CRF5501_B亚型(5.00%)、B+CRF01_AE亚型(2.50%);共有32例检出耐药突变位点。结论抗病毒治疗可有效改善HIV-1感染患者免疫功能,控制疾病进展,但长期治疗会引起AST、ALT、TBil、ALB、ALP等生化指标异常变化,临床应给予足够重视。

Objective To explore the relationship between antiretroviral therapy and disease progression in human immunodeficiency virus(HIV)infected patients.Methods A total of 215 HIV-1-infected patients admitted to Baoding People′s Hospital from January 2019 to January 2020 were selected as the research objects.Blood routine test,liver function index,biochemical index,immunological index,HIV-1 RNA load,clinical symptom and sign score before and after treatment were detected and compared.Genotyping and drug resistance were analyzed.Results The levels of AST,ALT,ALP,TBil,ALB in HIV-1 infected patients after treatment were higher than those before treatment(P<0.05).After treatment,CD4+T was higher than before treatment,CD8+T and HIV-1 RNA load were lower than before treatment(P<0.05).The HIV-1 negative conversion rate of HIV-1 infected patients in each time period after treatment was more than 90.00%,and the score of clinical symptoms and signs in each time period after treatment was lower than that before treatment(P<0.05).The subtypes of HIV-1 in HIV-1 infected patients were subtype A(3.50%),subtype B(7.50%),subtype C(31.50%),subtype B+C(9.50%),subtype CRF01_AE(36.00%),subtype CRF07_BC(4.50%),and subtype CRF5501_B(5.00%),B+CRF01_AE subtype(2.50%);a total of 32 cases of drug resistance mutation sites were detected.Conclusions Antiviral therapy can effectively improve the immune function of HIV-1 infected patients and control the progression of the disease,but long-term treatment will cause abnormal changes in AST,ALT,TBil,ALB,ALP and other biochemical indicators,which should be paid enough attention in clinical practice.