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目的研究中国HIV/AIDS患者应用高效抗逆转录病毒治疗后,其病毒学、免疫学疗效以及对耐药变异的影响。方法对辽宁、吉林、河南三省HIV/AIDS患者采用三种治疗方案治疗前后进行病毒载量、CD4+T淋巴细胞数、耐药变异基因型监测。结果经HAART治疗6个月,辽宁病例病毒载量下降5.7log10拷贝/ml,有8/11的病例病毒载量达到最低检测限(LDL)以下,病毒抑制率为72.7%。吉林病例病毒载量下降幅度3.8log10拷贝/ml,有11/24的病例病毒载量达到LDL以下,病毒抑制率为45.8%。差异均有统计学意义(P<0.05)。辽宁HIV/AIDS患者治疗6个月后CD4+T淋巴淋巴细胞平均增加164个/mm3,吉林患者平均增加24个/mm3,个体差异很大。在应用逆转录酶抑制剂后有耐药变异发生,且交叉耐药、多药耐药常见。结论在应用逆转录酶抑制剂时一定要加强监测,规范化管理,及时调整用药以节省有限的药物资源并防止耐药株的传播。
Objective To study the virological and immunological effects and the effect on drug-resistance variation in Chinese HIV / AIDS patients after using high-efficiency antiretroviral therapy. Methods The viral load, the number of CD4 + T lymphocytes and the resistant variant genotypes in HIV / AIDS patients in Liaoning, Jilin and Henan provinces before and after treatment with three kinds of treatment regimens were monitored. Results After HAART treatment for 6 months, the viral load in Liaoning Province decreased by 5.7log10 copies / ml. The viral load in 8/11 cases reached the lowest detection limit (LDL), and the virus inhibition rate was 72.7%. Jilin cases of viral load decreased by 3.8log10 copies / ml, 11/24 cases of viral load reached below LDL, the virus inhibition rate was 45.8%. The differences were statistically significant (P <0.05). After 6 months treatment, HIV / AIDS patients in Liaoning increased CD4 + T lymphocyte average 164 cells / mm3, while patients in Jilin increased 24 cells / mm3 on average. Resistance mutations occur after the application of reverse transcriptase inhibitors, and cross-resistance, multi-drug resistance is common. Conclusion In the application of reverse transcriptase inhibitors must be strengthened monitoring, standardized management, timely adjustment of medication to save limited drug resources and prevent the spread of resistant strains.