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目的探索病毒载量(VL)检测频率,对初始抗病毒治疗(ART)的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)治疗效果的影响。方法选取2013年11月至2014年8月,在重庆市公共卫生医疗救治中心就诊并接受抗病毒治疗的HIV/AIDS病人,分为VL检测低频组(检测次数≤2次/年)和VL检测高频组(检测次数≥3次/年),进行随访观察。收集两组病人的基线资料,同时记录两组病人治疗一年后VL的变化、CD4+T淋巴细胞(简称CD4细胞)的变化、换药情况和机会性感染发生情况。结果 VL检测高频组入组422例,VL检测低频组入组145例,两组病人基线情况在性别、年龄、婚姻状况、感染途径、基线CD4细胞计数水平、文化程度及经济水平方面的差异均无统计学意义。半年后CD4细胞水平变化,VL检测高频组高于VL检测低频组(P<0.05)。治疗一年后,两组VL检测结果在不同VL区间的分布差异无统计学意义,VL检测高频组换药率低于低频组(P<0.05),监测到机会性感染发生率VL检测高频组高于低频组(P<0.05)。结论对初始ART的病人进行较高频率的VL检测,可以提高治疗的临床效果。
Objective To explore the effect of detecting viral load (VL) on the treatment effect of HIV / AIDS patients (referred to as HIV / AIDS patients) in initial ART. Methods From November 2013 to August 2014, HIV / AIDS patients who were treated in Chongqing Public Health Medical Center and received antiviral treatment were divided into two groups: low-frequency VL test group (≤2 tests per year) and VL test High-frequency group (detection times ≥ 3 times / year), follow-up observation. The baseline data of two groups of patients were collected. The changes of VL, changes of CD4 + T lymphocytes (CD4 cells), dressing change and opportunistic infections were recorded after treatment for one year in both groups. Results There were 422 cases in VL group and 145 cases in VL group. There was significant difference in gender, age, marital status, infection route, baseline CD4 count, educational level and economic level between the two groups No statistical significance. After six months, the level of CD4 cells changed, VL high frequency group was higher than VL low frequency group (P <0.05). After one year of treatment, there was no significant difference in the distribution of VL between the two groups in different VL intervals. The frequency of dressing change in VL group was lower than that in low frequency group (P <0.05), and the incidence of opportunistic infection Frequency group was higher than low frequency group (P <0.05). Conclusion The higher frequency of VL detection in patients with initial ART can improve the clinical effect of treatment.