Tamrakar R, Tamrakar D, Shrestha S, Shrestha A
Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Kathmandu Univ Med J (KUMJ). 2019;17(67):217-222.
Background The major goal of antiretroviral therapy (ART) is immunological recovery and virological suppression. Immunological and virological response in People Living with HIV (PLHIV) undertaking ART has to be monitored to assess the treatment response, diagnosing treatment failure and switching antiretroviral therapy. Objective To assess the immunological and virological response to antiretroviral therapy among Human Immunodeficiency Virus (HIV) infected individuals. Method This is a cross-sectional study including people living with HIV (PLHIV) taking antiretroviral therapy for at least 6 months and was conducted in Dhulikhel Hospital in 2017. The socio-demographic profile, clinical characteristics, CD4 count and viral load were analyzed. Descriptive analysis of socio-demographic and other characteristics was done. Result Fifty-two patients undertaking antiretroviral therapy were included in the study with the mean age of 29.69±9.59 years at diagnosis. The majority of the patients were male (51.9%). Sexual transmission was the dominant mode of transmission (78.9%). The mean CD4 count at baseline was 244.08±214.32 cells/µL. Four patients (7.7%) had a virological failure. There was a discordance between immunological and virological response in patients taking antiretroviral therapy for more than 2 years' duration with four patients with a recent CD4 count of ≤250 cells/µL had virological suppression. The mean CD4 count at treatment increased from 229.65 cells/µL to 453.33 cells/µL after 1 year of commencement of antiretroviral therapy (p<0.001). Conclusion There are optimal CD4 recovery and virological suppression as expected with antiretroviral therapy use.
抗逆转录病毒疗法(ART)的主要目标是实现免疫恢复和病毒学抑制。必须对接受抗逆转录病毒疗法的艾滋病毒感染者(PLHIV)的免疫和病毒学反应进行监测,以评估治疗反应、诊断治疗失败并更换抗逆转录病毒疗法。目的:评估人类免疫缺陷病毒(HIV)感染者对抗逆转录病毒疗法的免疫和病毒学反应。方法:这是一项横断面研究,纳入了接受抗逆转录病毒疗法至少6个月的艾滋病毒感染者(PLHIV),于2017年在杜利凯尔医院进行。分析了社会人口统计学特征、临床特征、CD4细胞计数和病毒载量。对社会人口统计学和其他特征进行了描述性分析。结果:52例接受抗逆转录病毒疗法的患者纳入研究,诊断时的平均年龄为29.69±9.59岁。大多数患者为男性(51.9%)。性传播是主要传播方式(78.9%)。基线时的平均CD4细胞计数为244.08±214.32个/微升。4例患者(7.7%)出现病毒学失败。接受抗逆转录病毒疗法超过2年的患者中,免疫和病毒学反应存在不一致,4例近期CD4细胞计数≤250个/微升的患者实现了病毒学抑制。开始抗逆转录病毒疗法1年后,治疗时的平均CD4细胞计数从229.65个/微升增加到453.33个/微升(p<0.001)。结论:使用抗逆转录病毒疗法可实现预期的最佳CD4细胞恢复和病毒学抑制。