河南省艾滋病患者抗病毒治疗免疫学效果及其影响因素的研究

Study on the immunological improvement of treatment and the influencing factors among AIDS patients receiving HAART in Henan Province

目的了解河南省部分地区艾滋病患者抗病毒治疗免疫学效果,分析影响抗病毒治疗免疫学失败的主要危险因素。方法采用横断面调查方法对河南省接受国家免费一线抗病毒治疗时间大于半年的艾滋病患者进行问卷调查,并测定CD4+T淋巴细胞计数,了解调查对象抗病毒治疗免疫学效果,通过多因素Logistic回归分析确定艾滋病患者发生免疫学失败的影响因素。结果 706例调查对象接受抗病毒治疗时间为0.5～6年,治疗后CD4+T淋巴细胞数计数平均为(432±325)个/μl,其中171例(24.2%)患者调查时CD4+T淋巴细胞数计数<200 cells/μl。多因素Logistic回归分析显示,影响抗病毒治疗发生免疫学失败的危险因素是男性(AOR=1.480)、依从性差(AOR=1.765)和含去羟肌苷的治疗方案(AOR=1.724)。结论河南省部分地区抗病毒治疗免疫学效果较好,但仍有部分抗病毒治疗患者发生免疫学失败,建议加强抗病毒治疗的依从性管理,选用适合的初始抗病毒治疗方案,以更好地发挥抗病毒治疗的效果。

Objective To survey the immunological effect of treatment and the influencing factors among AIDS patients receiving HAART in Henan province. Methods AIDS patients after 6 months of national free first-line antiretroviral treatment were investigated by cross-sectional survey. Anticoagulated venous blood were collected after interviews. The absolute counts of CD4+T lymphocytes were detected by flow cytometry. The multivariate logistic regression method was used to analyze the influencing factors of immunological failure with AIDS-patients treatment. Results 706 cases of investigated AIDS patients had received first-line HAART from 0. 5 year to 6 years. The mean value of whole absolute counts of CD4+T lymphocytes was( 432 ± 325) after treatment 171( 24. 2%) AIDS patients among them had less than 200 cells /microlite of CD4. The multivariate logistic regression showed that the risk factors of CD4+T < 200 cells /microliter after treatment were male( AOR = 1. 480),poor adherence( AOR = 1. 765) and HAART with ddI( AOR = 1. 724). Conclusions The satisfactory immunology effect of treatment among most of AIDS patients receiving to HAART in Henan has been achieved,but there are still part of AIDS patients with immunological failure. The adherence management should be strengthened and a appropriate initial antiviral therapy program should be chosed with good effects on the antiviral therapy.