Spector S A, Hsia K, Yong F H, Cabral S, Fenton T, Fletcher C V, McNamara J, Mofenson L M, Starr S E
Dept. of Pediatrics, University of California, San Diego, La Jolla, CA 92093-0672, USA.
J Infect Dis. 2000 Dec;182(6):1769-73. doi: 10.1086/317621. Epub 2000 Oct 26.
This study examined the rate of decline in plasma human immunodeficiency virus type 1 (HIV-1) RNA levels to <400 and <50 copies/mL in children receiving highly active antiretroviral therapy (HAART) consisting of efavirenz, nelfinavir, and 1 or 2 nucleoside reverse-transcriptase inhibitors. Children receiving HAART achieved a plasma HIV-1 RNA level <400 copies/mL by a median of 4 weeks after initiation of therapy and a decline to <50 copies/mL by 20 weeks. Baseline plasma HIV-1 RNA levels affected the likelihood of achieving potent and sustained virus suppression, and children whose CD4 lymphocyte counts increased >70 cells/microL by 20 weeks on therapy were more likely to achieve durable virological and immunological benefit. These data provide time frames for virus suppression after the initiation of HAART that should be useful in evaluating the potential efficacy and durability of response of newly instituted combination antiretroviral therapy in HIV-1-infected children.
本研究调查了接受由依非韦伦、奈非那韦和1种或2种核苷类逆转录酶抑制剂组成的高效抗逆转录病毒疗法（HAART）的儿童，其血浆1型人类免疫缺陷病毒（HIV-1）RNA水平降至<400拷贝/mL和<50拷贝/mL的速率。接受HAART的儿童在开始治疗后中位数4周时血浆HIV-1 RNA水平降至<400拷贝/mL，至20周时降至<50拷贝/mL。基线血浆HIV-1 RNA水平影响实现有效且持续病毒抑制的可能性，并且在治疗20周时CD4淋巴细胞计数增加>70个细胞/微升的儿童更有可能获得持久的病毒学和免疫学益处。这些数据提供了HAART开始后病毒抑制的时间框架，这对于评估新实施的联合抗逆转录病毒疗法对HIV-1感染儿童的潜在疗效和反应持久性应是有用的。
