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目的评价二线抗反转录病毒治疗方案治疗艾滋病(AIDS)病人的疗效及安全性。方法对2012年1月至2013年12月,首都医科大学附属北京佑安医院感染中心接收的、用二线抗病毒治疗方案治疗的268例艾滋病病毒(HIV)感染者/AIDS病人,进行治疗后的病毒学和免疫学疗效及治疗安全性分析。结果 268例病人平均年龄(36.7±9.7)岁,其中男性占80.2%(215人),通过男男性行为传播占60.4%(162人)。在治疗48周后,病毒载量<50拷贝/mL者的比例由30.2%增加至84.3%,CD+4T淋巴细胞数量由基线(319±200)个/μL逐渐升高至(374±183)个/μL(12周)、(401±170)个/μL(24周)和(463±176)个/μL(<48周),与基线比差异均有统计学意义(P均<0.0001)。共有49例病人发生75次不良反应,其中血脂异常占41.3%(31/75),消化道症状占36.0%(27/75),多为轻中度不良反应。结论现行艾滋病二线抗病毒治疗方案的病毒学和免疫学疗效均较好,安全性可接受,但在临床应用中应注意血脂异常和消化道症状等不良反应。
Objective To evaluate the efficacy and safety of second-line antiretroviral therapy in the treatment of AIDS patients. Methods From January 2012 to December 2013, 268 HIV / AIDS patients treated with second-line antiviral treatment received at the Beijing You’an Hospital Infection Center, Capital Medical University, after treatment Virology and Immunology Efficacy and Treatment Safety Analysis. Results The average age of 268 patients (36.7 ± 9.7) years, of which 80.2% were male (215) and 60.4% (162) by MSM. After 48 weeks of treatment, the proportion of patients with viral load <50 copies / mL increased from 30.2% to 84.3%, and the number of CD + 4T lymphocytes gradually increased from baseline (319 ± 200) / μL to (374 ± 183) (P <0.0001) / μL (12 weeks), (401 ± 170) / μL (24 weeks) and (463 ± 176) / μL . A total of 49 patients had 75 adverse reactions, including dyslipidemia 41.3% (31/75), gastrointestinal symptoms accounted for 36.0% (27/75), mostly mild to moderate adverse reactions. Conclusions The current virological and immunological efficacy of second-line antiviral treatment of AIDS is good and the safety is acceptable. However, adverse reactions such as dyslipidemia and gastrointestinal symptoms should be noticed in clinical practice.