Ruan Gui-ren, Qiu Zhi-feng, Li Tai-sheng, Han Yang, Xie Jing, Zuo Ling-yan, Ma Xiao-jun, Liu Zheng-yin, Wang Ai-xia
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2006 Jul;45(7):569-72.
To investigate the efficacy and side effects of highly active antiretroviral therapy (HAART) in Chinese AIDS patients.
45 antiretroviral drug-naive AIDS patients were enrolled and divided into two groups by their baseline CD(4) count < 100/microl or > or = 100/microl. Clinical, virological and immunological outcomes as well as side effects were followed at baseline and at the end of month 1, 3, 6, 9, 12 after receiving HAART.
Among the 45 HIV/AIDS patients included, by the end of 12 months of HAART, the plasma viral load (VL) got a mean reduction by 2.8 lg copies/ml, CD(4) count had a mean gain of 187/microl, among which the naive phenotype increased by 68/microl and the memory phenotype by 119/microl. The CD(4)(+)CD(28)(+) T cell percentage went up from (62.5 +/- 25.8)% to (82.6 +/- 15.6)% (P < 0.001); and there was a significant reduction of CD(8)(+) T-cell activation. In the 31 patients with their baseline CD(4) count < 100/microl, 11 had a VL < 50 copies/ml, and 14 had fluctuations in their VL; while in 14 patients with their baseline CD(4) count > or = 100/microl, 10 had a VL < 50 copies/ml and 2 had fluctuations in their VL, respectively, with statistic significance between the two groups. CD(4) count showed a bi-phase increase during HAART and there was significant positive correlation between the change of CD(4) count and plasma VL. Throughout the 12 months of HAART, 39 patients had gastrointestinal side effects, 15 peripheral neuritis, 3 hepatic lesions, 4 hematological side effects and 1 renal calculus. 9 patients had adjustment of their initial therapy because of side effects.
Immune reconstitution as well as significant therapeutic effect was observed in advanced Chinese AIDS patients after HAART. Side effects were common during HAART, so close clinical attention is needed.
探讨高效抗逆转录病毒治疗（HAART）在中国艾滋病患者中的疗效及副作用。
纳入45例初治艾滋病患者，根据基线CD4细胞计数<100/μl或≥100/μl分为两组。在接受HAART治疗的基线期及治疗后第1、3、6、9、12个月末，观察临床、病毒学和免疫学指标以及副作用。
45例HIV/AIDS患者中，HAART治疗12个月后，血浆病毒载量（VL）平均下降2.8 lg拷贝/ml，CD4细胞计数平均增加187/μl，其中初始表型增加68/μl，记忆表型增加119/μl。CD4+CD28+T细胞百分比从（62.5±25.8）%升至（82.6±15.6）%（P<0.001）；CD8+T细胞活化明显降低。基线CD4细胞计数<100/μl的31例患者中，11例VL<50拷贝/ml，14例VL有波动；基线CD4细胞计数≥100/μl的14例患者中，分别有10例VL<50拷贝/ml，2例VL有波动，两组间差异有统计学意义。HAART治疗期间CD4细胞计数呈双相增加，CD4细胞计数变化与血浆VL呈显著正相关。HAART治疗的12个月中，39例患者有胃肠道副作用，15例有周围神经炎，3例有肝脏损害，4例有血液学副作用，1例有肾结石。9例患者因副作用调整了初始治疗方案。
晚期中国艾滋病患者HAART治疗后免疫重建及治疗效果显著。HAART治疗期间副作用常见，需密切临床关注。
