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[2005年法国的HIV感染医疗护理,NADIS对7416名患者的队列研究]

[Medical care for HIV infection in France in 2005, the NADIS cohort study on 7416 patients].

作者信息

Poizot-Martin I, Pugliese P, Enel P, Cuzin L, Billaud E, Duvivier C, Yazdanpanah Y

机构信息

Unité CISIH-Sud, Hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France.

出版信息

Med Mal Infect. 2006 Sep;36(9):454-9. doi: 10.1016/j.medmal.2006.07.003. Epub 2006 Oct 6.

Abstract

OBJECTIVE

This study had for aim to evaluate the immuno-virological and therapeutic profile of a cohort of 7416 HIV-1 infected patients followed in six French hospital with the Nadis software.

METHOD

This cross sectional and retrospective study was performed between June 1, 2004 and June 1, 2005. We analyzed the demographic (sex, age, HIV infection route), immunovirological, and therapeutic characteristics (last treatment prescribed) of the 7416 cohort patients.

RESULTS

The mean age was 43 years, 29% were women and 29% HCV/HBV co infected. The viral load was 1.9 log(10)copies/ml (IQR: 1.5-3.3) and the CD4 cells count was 452/mm(3) [IQR: 306-630]. Among the 5,913 antiretroviral treated patients, VL was less than 200 copies/ml for 74.7% of patients and 50% of them had a CD4 cell count superior to 500/mm(3); the drug regimen was 2 or 3 nucleosides reverse transcriptase inhibitors (NRTI) combined with one protease inhibitor (88% Ritonavir boosted) in 42% of the patients, 26% of them were treated with 2 NRTI and 1 non-NRTI, and 14% with 3NRTI. Patients with undetectable VL were followed 5.1/year versus 7.2 for non- VL controlled patients (P<10(-3)). The heterosexual route predominated among the new 531 HIV-diagnosed patients among whom 25% had a median CD4 cell count of 242/ m(3).

CONCLUSION

Close to 75% of antiretroviral treated patients had a VL<200 copies/ml but 15% kept a low CD4 cell count. The characteristics of recently diagnosed HIV positive patients stresses the need for more information on prevention and an early diagnosis.

摘要

目的

本研究旨在通过Nadis软件评估在六家法国医院接受治疗的7416例HIV-1感染患者队列的免疫病毒学和治疗情况。

方法

本横断面回顾性研究于2004年6月1日至2005年6月1日进行。我们分析了7416例队列患者的人口统计学特征(性别、年龄、HIV感染途径)、免疫病毒学特征和治疗特征(最后开具的治疗方案)。

结果

平均年龄为43岁,29%为女性,29%合并HCV/HBV感染。病毒载量为1.9 log(10)拷贝/毫升(四分位间距:1.5 - 3.3),CD4细胞计数为452/立方毫米[四分位间距:306 - 630]。在5913例接受抗逆转录病毒治疗的患者中,74.7%的患者病毒载量低于200拷贝/毫升,其中50%的患者CD4细胞计数高于500/立方毫米;42%的患者的治疗方案为2种或3种核苷类逆转录酶抑制剂(NRTI)联合1种蛋白酶抑制剂(88%为利托那韦增强型),26%的患者接受2种NRTI和1种非NRTI治疗,14%的患者接受3种NRTI治疗。病毒载量不可检测的患者每年随访5.1次,而病毒载量未得到控制的患者每年随访7.2次(P<10⁻³)。在新诊断的531例HIV患者中,异性传播途径占主导,其中25%的患者CD4细胞计数中位数为242/立方毫米。

结论

近75%接受抗逆转录病毒治疗的患者病毒载量<200拷贝/毫升,但15%的患者CD4细胞计数仍较低。近期诊断的HIV阳性患者的特征强调了需要更多关于预防和早期诊断的信息。

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