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目的评价替诺福韦(TDF)+拉米夫定(3TC)+依菲韦伦(EFV)或TDF+3TC+克力芝(LPV/r)治疗方案,对艾滋病病毒(HIV)合并感染乙型肝炎病毒(HBV)患者的治疗效果,对合并感染者死亡因素进行分析,为临床抗病毒治疗提供参考。方法对46例HIV/HBV合并感染患者实施TDF+3TC+EFV或TDF+3TC+LPV/r方案治疗,治疗3、6、12个月后随访,分析CD4+T淋巴细胞、HIV RNA、HBV DNA、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)等指标的变化。结果 46例HIV/HBV合并感染患者治疗3、6、12个月后,CD4+T淋巴细胞数分别增加了76个/μL、138个/μL和145个/μL;治疗6、12个月后,HIV-RNA抑制率分别为79.49%和95.56%,HBV-DNA抑制率分别为77.14%和97.06%;抗病毒治疗12个月内AST、ALT先升后降,治疗6个月时,除2例肝功能异常外,其余肝功均复常;HIV/HBV合并感染者病死率为10.87%。结论 TDF+3TC+EFV或TDF+3TC+LPV/r方案对HIV和HBV均有很强的抑制作用,是一种高效、安全的治疗HIV/HBV合并感染的首选方案。
Objectives To evaluate the efficacy and safety of tenofovir (TDF) + lamivudine (3TC) plus efavirenz (EFV) or TDF + 3TC plus carbachol (LPV / r) Hepatitis B virus (HBV) in patients with the treatment effect of death in patients with infection were analyzed for clinical anti-viral treatment provide a reference. Methods 46 cases of HIV / HBV co-infection were treated with TDF + 3TC + EFV or TDF + 3TC + LPV / r regimen. The patients were followed up for 3, 6 and 12 months. CD4 + T lymphocytes, , Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and other indicators of change. Results The number of CD4 + T lymphocytes increased by 76 / μL, 138 / μL and 145 / μL respectively in 46 cases of HIV / HBV co-infected patients at 3, 6 and 12 months after treatment. After 6 and 12 months , The inhibition rate of HIV-RNA was 79.49% and 95.56% respectively, and the inhibition rates of HBV-DNA were 77.14% and 97.06% respectively. AST and ALT increased first and then decreased within 12 months after antivirus treatment. Cases of abnormal liver function, the rest of the liver function are normal; HIV / HBV co-infection mortality was 10.87%. Conclusion The TDF + 3TC + EFV or TDF + 3TC + LPV / r regimen has a strong inhibitory effect on both HIV and HBV and is an effective and safe first choice for the treatment of HIV / HBV co-infection.