Re M C, Ramazzotti E, Manfredi R, Furlini G, Vignoli M, Maldini C, Borderi M, La Placa M
Department of Clinical and Experimental Medicine, Section of Microbiology, University of Bologna, Via Massarenti, 9-40138, Bologna, Italy.
J Clin Virol. 2000 Jun;17(1):5-11. doi: 10.1016/s1386-6532(00)00064-0.
The efficacy of highly active antiretroviral therapy (HAART) was prospectively monitored in HIV-1 seropositive patients by analyzing HIV-1 RNA viral load.
The aim of the study was to evaluate the viral load course in two different groups of patients (group 1: CD4>400/mm(3), group 2: CD4<200/mm(3)) during a period ranging from 9 to 25 months.
HIV-1 viral load, at the start and during HAART, was analyzed in 117 patients who had previously been treated only with two anti-transcriptase drugs but were naive for protease inhibitors.
The results showed that, after the beginning of therapy, high plasma HIV-1 RNA levels dropped to undetectable values (<50 copies HIV-RNA/ml) in one third of patients over a mean period of about 9 months irrespective of the initial CD4 cell count, even though a viral reduction of at least 2log(s) in a significantly shorter period of time (P<0.001) was observed only among patients who began retroviral therapy with a higher CD4 cell count.
The response to HAART was not dramatically affected by the initial CD4 count. Though restricted to a small number of subjects, the data support the idea that therapeutic intervention can be effective even in an advanced stage of HIV-1 infection, when patients show a decreased number of CD4 T-lymphocytes.
通过分析HIV-1 RNA病毒载量，对HIV-1血清阳性患者的高效抗逆转录病毒疗法（HAART）疗效进行前瞻性监测。
本研究的目的是评估两组不同患者（第1组：CD4>400/mm³，第2组：CD4<200/mm³）在9至25个月期间的病毒载量变化过程。
对117例先前仅接受过两种抗转录酶药物治疗但未使用过蛋白酶抑制剂的患者，在开始HAART时及治疗期间分析HIV-1病毒载量。
结果显示，治疗开始后，三分之一的患者血浆HIV-1 RNA高水平在约9个月的平均时间内降至检测不到的值（<50拷贝HIV-RNA/ml），无论初始CD4细胞计数如何，尽管仅在开始抗逆转录病毒治疗时CD4细胞计数较高的患者中观察到在明显更短的时间内病毒减少至少2log（P<0.001）。
对HAART的反应未受到初始CD4计数的显著影响。尽管样本量有限，但数据支持即使在HIV-1感染晚期，当患者CD4 T淋巴细胞数量减少时，治疗干预仍可能有效的观点。
