Hsu Wen-Ming, Chiou Shih-Hwa, Chen Steve S-L, Shyong Mon-Ping, Ho Chi-Kung, Chen Shih-Jen, Wu Chih-Chiau, Kung Szu-Hao, Chi Chin-Wen
Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University and Institutes of Clinical Medicine, Taipei, Taiwan, ROC.
Ophthalmologica. 2004 Sep-Oct;218(5):328-32. doi: 10.1159/000079475.
The aim of the present study was to evaluate the impact of highly active antiretroviral therapy (HAART) on HIV viral load of plasma and intraocular fluids in AIDS patients with ophthalmic opportunistic infections. We further compared the treatment effect of HAART on these patients. From June 1997 to July 2003, we examined and followed up the ophthalmic conditions of 49 patients receiving HAART with ophthalmic diseases during this period. The method of reverse-transcriptase polymerase chain reaction was used to detect and monitor HIV load in plasma and/or aqueous humor of AIDS patients. Before HAART, the HIV levels in the plasma and aqueous humor in 8 AIDS patients with ophthalmic opportunistic infections were significantly higher than those in 6 patients with HIV-related retinopathy (p < 0.05). Compared to the eye findings and clinical improvement, HIV loads of aqueous humor in 10 of 14 AIDS patients (6 with HIV-related retinopathy, 5 with cytomegalovirus retinitis, 2 with toxoplasmic retinitis and 1 with cryptococcal chorioretinitis) declined to undetectable levels (< 400 copies/ml) after 4-8 months of HAART. HIV virus levels in the plasma of AIDS patients were significantly decreased, and the CD4 counts of these patients were significantly increased (Wilcoxon test) after initiation of HAART.
本研究的目的是评估高效抗逆转录病毒疗法(HAART)对患有眼部机会性感染的艾滋病患者血浆和眼内液中HIV病毒载量的影响。我们进一步比较了HAART对这些患者的治疗效果。1997年6月至2003年7月,我们对在此期间接受HAART治疗且患有眼科疾病的49例患者的眼部状况进行了检查和随访。采用逆转录聚合酶链反应方法检测和监测艾滋病患者血浆和/或房水中的HIV载量。在HAART治疗前,8例患有眼部机会性感染的艾滋病患者血浆和房水中的HIV水平显著高于6例患有HIV相关性视网膜病变的患者(p<0.05)。与眼部检查结果和临床改善情况相比,14例艾滋病患者中有10例(6例患有HIV相关性视网膜病变、5例患有巨细胞病毒性视网膜炎、2例患有弓形虫性视网膜炎和1例患有隐球菌性脉络膜视网膜炎)在接受HAART治疗4-8个月后,房水中的HIV载量降至检测不到的水平(<400拷贝/ml)。艾滋病患者血浆中的HIV病毒水平显著下降,且在开始HAART治疗后,这些患者的CD4细胞计数显著增加(Wilcoxon检验)。