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[刚果布拉柴维尔大学医院血液科对感染艾滋病毒的成年人进行抗逆转录病毒治疗的评估]

[Evaluation of antiretroviral therapy in HIV-infected adults in the Department of Haematology, University Hospital of Brazzavllle, Congo].

作者信息

Dokekias A Elira, Galiba F O Atipo, Bokilo A Dzia Lepfoundzou, Ntsimba P, Nsitou M B, Malanda F, Basseila G Boukatou

机构信息

Service hématologie, CHU Brazzaville, BP 13027 RP, Brazzaville, Congo.

出版信息

Bull Soc Pathol Exot. 2008 Apr;101(2):109-12.

Abstract

A retrospective study was conducted during 32 months; from 1 May 2003 to 30 December 2005 in haematology department. The objective of the study was to assess the effectiveness of the anti retroviral therapy 157 patients receiving antiretroviral treatment for at least a twelve month-period and presenting AIDS symptoms based on revised CDC criteria were included. The average number of initial T4 lymphocytes is 133/mm3 (extremes 1 and 385) and the initial plasmatic average viral load, quantified in 96 patients is 214,000 copies (extreme 30,000 et 999,000) The initial antiretroviral combinations were as follows: ZDV or D4T + LMV + NVP (59.2%); ZDV or D4T + LMV + EFV (28.7%), ZDV or D4T + LMV + IDNV (8.9%); ZDV or D4T + DDI + NVP (3.2%). The results of the study are: observance rate during the first 12 months (84%), antiretroviral therapy taken irregularly (10.8%), early submission of therapy (5.2%), weight gain after 24 months: +18 kgs, clinical response globally positive. The immune response is characterised by an average increase of 353/mm3 of CD4 after 24 months. Among 96 patients tested, the plasmatic viral load was undetectable in 71% of cases after a 12 month-follow up. Mild adverse drug effects have been noticed, represented by cutaneous and nervous toxicity anaemia and digestive disorders due to indinavir These therapeutic results confirm the importance of the antiretroviral therapy in the improvement of the quality of life of HIV/AIDS patients but a concern remains on the possible drug resistance still not documented.

摘要

在32个月期间进行了一项回顾性研究;从2003年5月1日至2005年12月31日在血液科进行。该研究的目的是评估抗逆转录病毒疗法的有效性,纳入了157名接受抗逆转录病毒治疗至少12个月且根据修订的美国疾病控制与预防中心标准出现艾滋病症状的患者。初始T4淋巴细胞的平均数量为133/mm³(范围为1至385),96名患者的初始血浆平均病毒载量为214,000拷贝(范围为30,000至999,000)。初始抗逆转录病毒联合用药方案如下:齐多夫定或司他夫定+拉米夫定+奈韦拉平(59.2%);齐多夫定或司他夫定+拉米夫定+依非韦伦(28.7%),齐多夫定或司他夫定+拉米夫定+茚地那韦(8.9%);齐多夫定或司他夫定+去羟肌苷+奈韦拉平(3.2%)。研究结果如下:前12个月的依从率为84%,抗逆转录病毒治疗不规则服用的比例为10.8%,提前停药的比例为5.2%,24个月后体重增加:18公斤,总体临床反应为阳性。免疫反应的特征是24个月后CD4平均增加353/mm³。在96名接受检测的患者中,经过12个月的随访,71%的病例血浆病毒载量检测不到。已注意到轻微的药物不良反应,表现为皮肤和神经毒性、贫血以及因茚地那韦引起的消化系统疾病。这些治疗结果证实了抗逆转录病毒疗法在改善艾滋病毒/艾滋病患者生活质量方面的重要性,但对可能仍未记录的耐药性问题仍存在担忧。

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