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目的研究河南省人类免疫缺陷病毒/艾滋病(HIV/AIDS)患者应用高效抗逆转录病毒治疗后治疗效果及耐药变异产生情况。方法对采用2种治疗方案的河南省HIV/AIDS患者进行病毒载量、CD4+T淋巴细胞数、耐药变异基因型监测。结果2种治疗方案都在部分HIV/AIDS患者身上取得病毒载量抑制和提升CD4+T淋巴细胞数效果,但用药后均有耐药变异发生,2005年D4T/ddI/NVP、AZT/ddI/NVP高度耐药相关突变率分别为19.7%,16.2%;2006年分别为19.4%,19.5%。结论河南省HIV/AIDS患者应用高效抗逆转录病毒治疗(HAART)治疗基本上取得了预期的疗效,但在应用逆转录酶抑制剂后有耐药变异发生,且多为交叉耐药、多药耐药。所以应用逆转录酶抑制剂时要加强耐药监测,规范管理,及时调查用药以节省有限的药物资源并防止耐药株的产生。
Objective To study the therapeutic effect and drug resistance variation of patients with HIV / AIDS in Henan Province after using high-efficiency antiretroviral therapy. Methods The viral load, the number of CD4 + T lymphocytes and the resistant variant genotypes of HIV / AIDS patients in two kinds of treatment regimens were monitored. Results Both treatment regimens achieved viral load suppression and CD4 + T lymphocyte count in some HIV / AIDS patients. However, both drug resistance mutations occurred after treatment. In 2005, D4T / ddI / NVP, AZT / ddI / The mutation rates of high resistance to NVP were 19.7% and 16.2% respectively; in 2006 they were 19.4% and 19.5% respectively. Conclusion HAART treatment in HIV / AIDS patients in Henan Province basically achieved the expected therapeutic effect, but there was resistance mutation after the reverse transcriptase inhibitor was applied, and most of them were cross-resistant and multi-drug Resistance. Therefore, the application of reverse transcriptase inhibitors to strengthen drug resistance monitoring, standardized management, timely investigation of medication to save limited drug resources and prevent the emergence of drug-resistant strains.