国家免费艾滋病抗病毒药物治疗4年疗效观察

Effect Observation for Free Highly Active Antiretroviral Therapy for 4 Years

关键词:  艾滋病  抗病毒治疗  疗效  观察

Key words:  AIDS  highly active antiretroviral therapy(HARRT)  effect  observation

摘要:

目的 观察国家免费艾滋病抗病毒药物治疗效果。方法 回顾性分析嘉兴市纳入国家免费高效抗病毒治疗的艾滋病病例治疗效果。结果 ①随着治疗时间增加，169例病例CD4⁺T淋巴细胞计数均值和增长值均呈明显上升趋势，均值由基线的(155.36±99.86)μL^-1持续上升至48个月时的(360.98±141.09)μL^-1(b=0.362，F=182.07，P<0.001)；增长值由6个月时的(84.43±81.31)μL^-1不断上升至48个月时的(242.88±140.23)μL^-1(b=0.364，F=134.82，P<0.001)。②对基线CD4⁺T淋巴细胞按照≤200 μL^-1和>200~350 μL^-1分组后进行不同治疗阶段抗病毒效果分析发现，2组各治疗阶段CD4⁺T淋巴细胞计数均明显增长(P<0.01)，随着治疗时间的增加，2组CD4⁺T淋巴细胞计数增长均呈线性趋势(≤200 μL^-1组，F线性=274.36，P<0.001；>200~350 μL^-1组，F线性=102.25，P<0.001)；同一疗程不同基线组分析表明，各疗程不同基线组之间CD4⁺T淋巴细胞增长差异均无统计学意义。③治疗满1，2，3年的HIV病毒抑制率(病毒载量<400 cp·mL^-1)分别为68.55%(109/159)、77.36%(123/159)、87.42%(139/159)，抗病毒治疗失败率(病毒载量≥10 000 cp·mL^-1)分别为12.58%(20/159)、8.80%(14/159)、3.77%(6/159)。④抗病毒治疗失败病例中有10例检测出耐药基因。结论 国家免费艾滋病抗病毒药物治疗4年疗效明显，但仍有不足，应采取相应措施改进。

Abstract:

OBJECTIVE To observe the effect of free highly active antiretroviral therapy(HARRT). METHODS Using a retrospective investigation method and analyzing therapeutic effect of HARRT in Jiaxing. RESULTS ①The CD4⁺T lymphocyte average and increase values of 169 HIV/AIDS cases were both shown a significant uptrend. The average values were from (155.36±99.86)μL^-1 in base line to (360.98±141.09)μL^-1 in the 48 months (b=0.362, F=182.07, P<0.001), and the increase values were from (84.43±81.31)μL^-1 in the 6 months to (242.88±140.23)μL^-1 in the 48 months (b=0.364, F=134.82, P<0.001). ②There was a significant growth of CD4⁺T in each treatment phases of HIV/AIDS who were assigned into ≤200 μL^-1 and >200-350 μL^-1 groups (P<0.01). Furthermore, the CD4⁺T values had shown a line growth trend in ≤200 μL^-1 and >200-350 μL^-1 base line groups, respectively (≤200 μL^-1 group, F=274.36, P<0.001; >200-350 μL^-1 group, F=102.25, P<0.001). Results comparison of groups in each same treatment phases were not significant. ③The virus inhibition ratios [viral load (VL)<400 cp·mL^-1] were 68.55% (109/159), 77.36% (123/159), 87.42% (139/159), and the failure rates (VL≥10 000 cp·mL^-1) were 12.58% (20/159), 8.80% (14/159), 3.77% (6/159) when cases were treated with 1, 2, 3 year. ④Drug resistance genes had been detected in 10 of the treatment failure cases. CONCLUSION The national free highly active antiretroviral therapy for 4 years has a remarkable curative effect, it is insufficient yet. Some improvement measures are needed in future.