论文部分内容阅读
目的评估中国艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人),接受二线高效抗反转录病毒治疗(HARRT)3年的疗效评价。方法对2010年1月至2016年12月在中国医科大学附属第一医院,接受一线HAART失败的转入二线HAART的89例HIV/AIDS病人进行随访,评估HAART后3年的病毒学和免疫学疗效及临床结局。结果 89例HIV/AIDS病人中位年龄37岁;男性88例,占98.88%;男男性行为途径感染69例,占77.53%;接受二线HAART中位时间为30个月。二线治疗基线时HIV病毒载量中位值为4.51Log,治疗后6、12、24和36个月,HIV病毒载量<50拷贝/mL的比例分别为69.74%、79.41%、93.62%和92.59%,HIV病毒载量<400拷贝/mL的比例分别为92.11%、95.59%、95.74%和96.30%。二线基线CD4~+T淋巴细胞(简称CD4细胞)计数为(167.18±144.93)个/μ>L,治疗后6、12、24和36个月CD4~+T淋巴细胞计数增加至(276.27±143.66)个/μL、(329.47±151.05)个/μL、(420.71±145.27)个/μL和(531.27±209.32)个/μL,上述各个时间点的CD4细胞计数与治疗前基线比较差异均有统计学意义(P<0.001)。研究随访结束时,仅1例病人发生病毒学失败,4例发生低病毒血症。结论一线治疗失败病人更换以克力芝为基础的二线HAART方案,可获得良好的长期持续病毒应答和免疫重建,在保证服药依从性基础上,不容易发生二线治疗失败。
Objective To assess the efficacy of second-line anti-retroviral therapy (HARRT) for three years in Chinese HIV / AIDS patients (HIV / AIDS patients). METHODS: From January 2010 to December 2016, 89 HIV / AIDS patients admitted to the First Affiliated Hospital of China Medical University who had failed first-line HAART and who were admitted to second-line HAART were followed up to assess the virology and immunology Efficacy and clinical outcome. Results The median age of 89 HIV / AIDS patients was 37 years. 88 were male, accounting for 98.88%. 69 were male sexual behavior infection, accounting for 77.53%. The median second-line HAART was 30 months. The median HIV viral load at second-line treatment was 4.51 log at baseline, and at 6, 12, 24 and 36 months after treatment, the rates of HIV viral load <50 copies / mL were 69.74%, 79.41%, 93.62% and 92.59, respectively %, And the rates of HIV viral load <400 copies / mL were 92.11%, 95.59%, 95.74% and 96.30%, respectively. The counts of CD4 ~ + T lymphocytes in second-line baseline were (167.18 ± 144.93) / μ> L, and the counts of CD4 ~ + T lymphocytes increased to (276.27 ± 143.66) at 6, 12, 24 and 36 months ) / ΜL, (329.47 ± 151.05) /μL, (420.71 ± 145.25) / μL and (531.27 ± 209.32) / μL, respectively. The differences of CD4 cell count at all time points from baseline before treatment were statistically significant Significance (P <0.001). At the end of the study visit, only 1 patient had a virological failure and 4 had low viremia. Conclusions The first-line treatment fails patients to replace second-line HAART regimen based on ganoderma lucidum can obtain good long-term sustained virus response and immune reconstitution. Based on the compliance of medication, it is not easy to have second-line treatment failure.