Chen Xie-jie, Tang Xiao-ping, Cai Wei-ping, Zhang Jian-sheng, Chen Jin-feng, Liu Qi-cai, Zhong Huo-lin, He Hao-lan, Li Ling-hua, Zhao Bin, Shang Hong
No 8 People's Hospital of Guangzhou, Guangzhou 510060, China.
Zhonghua Nei Ke Za Zhi. 2011 Jan;50(1):59-62.
To evaluate the therapeutic effect of highly active anti-retroviral therapy (HAART) in treatment-naïve Chinese patients with AIDS, to provide evidences for standardizing HAART.
Seventy-four treatment-naive AIDS patients were initiated with HAART and followed up regularly for 3 years. The clinical and laboratory data, side effects and drug resistance were observed and analyzed during the follow-up period.
Of the 74 patients, 46 were males and 28 were females, with the average age being 42 years. The mean HIV viral load was (2.2 ± 2.0) × 10(5) copies/ml and the baseline mean CD(4)(+)T lymphocyte count was (62 ± 71) cells/µl before treatment. After treatment for 3, 6, 12, 18, 24, 30 and 36 months, the percentage of undetectable HIV viral road (less than 50 copies/ml) was 71.6%, 83.8%, 75.7%, 77.0%, 82.4%, 81.1% and 79.7% respectively, and CD(4)(+)T lymphocyte count ascended to (167 ± 105), (177 ± 129), (238 ± 137), (290 ± 158), (304 ± 191), (331 ± 175) and (352 ± 202) cells/µl. The increase in amplitude of CD(4)(+)T lymphocyte count in different periods examined was different, with the period of 0-3 months post-treatment demonstrating the most obvious augmentation (P < 0.01). The most common adverse reactions were liver function injury (52/74, 70.3%), hyperlipemia (52/74, 70.3%), hematopoietic inhibition of the bone marrow (33/74, 44.6%), peripheral neuritis (32/74, 43.2%) and lipoatrophy (26/74, 35.1%). Clinical drug resistance were found in nine patients and HIV gene mutations were detected in these patients.
Chinese treatment-naive AIDS patients have achieved good virological and immunological response to generic-drug-predominant HAART regimes with low drug resistance, but relatively more side effects.
评估高效抗逆转录病毒治疗(HAART)对初治中国艾滋病患者的治疗效果,为规范HAART提供依据。
74例初治艾滋病患者接受HAART治疗并定期随访3年。随访期间观察并分析临床和实验室数据、副作用及耐药情况。
74例患者中,男性46例,女性28例,平均年龄42岁。治疗前平均HIV病毒载量为(2.2±2.0)×10⁵拷贝/ml,基线平均CD4⁺T淋巴细胞计数为(62±71)个/μl。治疗3、6、12、18、24、30和36个月后,HIV病毒载量低于检测下限(<50拷贝/ml)的比例分别为71.6%、83.8%、75.7%、77.0%、82.4%、81.1%和79.7%,CD4⁺T淋巴细胞计数升至(167±105)、(177±129)、(238±137)、(290±158)、(304±191)、(331±175)和(352±202)个/μl。不同检测时间段CD4⁺T淋巴细胞计数升高幅度不同,治疗后0 - 3个月升高最明显(P<0.01)。最常见的不良反应为肝功能损害(52/74,70.3%)、高脂血症(52/74,70.3%)、骨髓造血抑制(33/74,44.6%)、周围神经炎(32/74,43.2%)和脂肪萎缩(26/74,35.1%)。9例患者出现临床耐药,检测到HIV基因突变。
初治中国艾滋病患者对以仿制药为主的HAART方案有良好的病毒学和免疫学反应,耐药率低,但副作用相对较多。