Kyaw Nyan Lin, Thanachartwet Vipa, Kiertiburanakul Sasisopin, Desakorn Varunee, Chamnanchanunt Supat, Chierakul Wirongrong, Manosuthi Weerawat, Pitisuttithum Punnee, Sungkanuparph Somnuek
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2013 Mar;44(2):232-43.
A retrospective study was conducted by reviewing 459 medical records of adult treatment naive HIV patients who received a fixed dose combination of GPO-VIR-S (stavudine, lamivudine and nevirapine) or GPO-VIR-Z (zidovudine, lamivudine and nevirapine) at Ramathibodi Hospital in Bangkok, Thailand during 2002-2009 following Thai National Treatment Guideline for adults with HIV. The aim of this study was to assess the association between the baseline CD4 cell count and outcome. The median CD4 cell count at baseline, 6, 12 and 102 months were 102 cells/microl, 213 cells/microl, 274 cells/microl and 423 cells/microl. The virologic response (p=0.327), virologic rebound (p=0.626), adverse effects of anti-retroviral therapy (ART) (p=0.976), switching to other ART (p=0.245), occurrence of immune reconstitution inflammatory syndrome (IRIS) (p>0.05) and occurrence of drug resistance (p=0.952) were not significantly associated with baseline CD4 count. The Kaplan-Meier estimate showed the median time (95% CI) to achieve virologic response was 10.4 (9.8-11.0) months and the median time to achieve virologic rebound was 30.0 (21.6-38.4) months after initiation of ART. Analysis showed the median time to achieved virologic response (p=0.401) and virologic rebound (p=0.562) were not significantly associated with the baseline CD4 count. This study shows the outcome after onset of ART did not vary by baseline CD4 cell count.
一项回顾性研究通过查阅459例成年初治HIV患者的病历进行，这些患者于2002年至2009年期间在泰国曼谷的拉玛蒂博迪医院按照泰国成人HIV治疗指南接受了固定剂量组合的GPO-VIR-S（司他夫定、拉米夫定和奈韦拉平）或GPO-VIR-Z（齐多夫定、拉米夫定和奈韦拉平）治疗。本研究的目的是评估基线CD4细胞计数与治疗结果之间的关联。基线、6个月、12个月和102个月时的CD4细胞计数中位数分别为102个细胞/微升、213个细胞/微升、274个细胞/微升和423个细胞/微升。病毒学应答（p=0.327）、病毒学反弹（p=0.626）、抗逆转录病毒治疗（ART）的不良反应（p=0.976）、换用其他ART（p=0.245）、免疫重建炎症综合征（IRIS）的发生（p＞0.05）以及耐药的发生（p=0.952）与基线CD4计数均无显著关联。Kaplan-Meier估计显示，开始ART后达到病毒学应答的中位时间（95%CI）为10.4（9.8-11.0）个月，达到病毒学反弹的中位时间为30.0（21.6-38.4）个月。分析显示，达到病毒学应答（p=0.401）和病毒学反弹（p=0.562）的中位时间与基线CD4计数均无显著关联。本研究表明，ART开始后的治疗结果不因基线CD4细胞计数而有所不同。
