高效抗逆转录病毒疗法（HAART）的不一致反应：基因型指导治疗方案改变后患者体内HIV毒株的病毒血症和复制能力降低

Discordant response to HAART: reduction of viremia and replicative capacity of HIV strains in patients after genotype guided change of therapy.

作者信息

Sarmati L, Montano M, Dori L, Buonomini A R, D'Ettorre G, Vullo V, Andreoni M

机构信息

Department of Public Health, University of Rome Tor Vergata, Rome.

出版信息

New Microbiol. 2004 Apr;27(2 Suppl 1):95-8.

PMID:15646070

Abstract

The aim of this study was to evaluate outcome after a genotype guided change of therapy in 18 patients failing HAART. Patients were divided into two groups according to the response to therapy: immune responders (12 patients with immune recovery defined as having more than 100 CD4 cells compared to baseline value), and 6 failing patients (without immune recovery). At month 12 after genotype change of therapy a significant difference in the decrease of HIV-RNA viral load between the two groups of patients was detected (mean -1.95 and +0.04 log HIV-RNA copies/ml, p=0.04). One year after the change of therapy, all but one patients experienced a decrease in the replication capacity of HIV strains. Particularly, the HIV replication capacity of HIV strains decreased from 52% (range 14-98%) to 15.2% (range 0.1-74.5%). The HIV strains of patients failing HAART showed a progressive impaired replication capacity. In patients failing HAART the impaired replication capacity of HIV strains could justify the persistence of an immune recovery.

摘要

本研究的目的是评估18例接受高效抗逆转录病毒治疗（HAART）失败的患者在基因型指导下改变治疗后的结果。根据治疗反应将患者分为两组：免疫反应者（12例免疫恢复患者，定义为与基线值相比CD4细胞超过100个）和6例治疗失败患者（无免疫恢复）。在治疗基因型改变后的第12个月，检测到两组患者在HIV-RNA病毒载量下降方面存在显著差异（平均-1.95和+0.04 log HIV-RNA拷贝/ml，p=0.04）。治疗改变一年后，除一名患者外，所有患者的HIV毒株复制能力均下降。特别是，HIV毒株的HIV复制能力从52%（范围14-98%）降至15.2%（范围0.1-74.5%）。接受HAART治疗失败的患者的HIV毒株显示出逐渐受损的复制能力。在接受HAART治疗失败的患者中，HIV毒株复制能力受损可能是免疫恢复持续存在的原因。