Mena Maurizio, Magnani Carlo, Villa Massimo, Re Tiziana, Perini Paolo, De Paschale Massimo, Cagnin Debora, Cerulli Teresa, Clerici Pierangelo, Viganò Paolo
Department of Infectious Diseases, Ospedale Civile of Legnano, Legnano, Milan, Italy.
New Microbiol. 2010 Jul;33(3):207-14.
The aim of this study was to characterise the AIDS presenters diagnosed between 2000 and 2008 in Legnano (Italy), and describe their initial response to highly active antiretroviral therapy (HAART) and trends over time. Seventy-six (48.7%) of 156 patients diagnosed as having AIDS in the period 2000-2008 were AIDS presenters. The proportion of AIDS presenters increased from 23.8% in 2000 to 70.6% in 2008 (p = 0.009). The major risk factors were heterosexual transmission and a foreign place of birth, and did not significantly change over time. The median CD4+ cell count at diagnosis was 30 cells/microl and the median level of HIV RNA was 5.38 log copies/ml, with no differences between the transmission risk groups. Fifteen AIDS presenters died of AIDS-defining diseases; the others started HAART (72% with 2 NRTIs + boosted PI), and 40% after a drug resistance test. The median duration of the initial HAART was 107 days. After three months, 34% of the patients had undetectable HIV-RNA levels and the median CD4+ cell count was 140 cells/microl; the corresponding figures after 12, 24 and 48 months were respectively 84%, 82.3% and 94.1%, and 310, 370 and 380 cells/microl. In conclusion, the AIDS presenters were mainly heterosexual men and immigrants. Their proportion increased significantly over time, and a substantial proportion maintained an immunovirological response to HAART.
本研究旨在对2000年至2008年期间在意大利莱尼亚诺被诊断出的艾滋病患者进行特征描述，并描述他们对高效抗逆转录病毒疗法（HAART）的初始反应及随时间的变化趋势。在2000 - 2008年期间被诊断为患有艾滋病的156名患者中，有76名（48.7%）是艾滋病患者。艾滋病患者的比例从2000年的23.8%增至2008年的70.6%（p = 0.009）。主要危险因素为异性传播和出生于国外，且随时间未发生显著变化。诊断时CD4 + 细胞计数的中位数为30个/微升，HIV RNA水平的中位数为5.38 log拷贝/毫升，不同传播风险组之间无差异。15名艾滋病患者死于艾滋病界定疾病；其他患者开始接受HAART（72%采用2种核苷类逆转录酶抑制剂 + 增强型蛋白酶抑制剂），40%在进行耐药性检测后开始治疗。初始HAART的中位疗程为107天。三个月后，34%的患者HIV - RNA水平检测不到，CD4 + 细胞计数的中位数为140个/微升；12个月、24个月和48个月后的相应数据分别为84%、82.3%和94.1%，以及310个/微升、370个/微升和380个/微升。总之，艾滋病患者主要是异性恋男性和移民。其比例随时间显著增加，且相当一部分患者对HAART保持免疫病毒学反应。
