HIV/AIDS患者HAART治疗中免疫重建炎性综合症

目的探讨艾滋病高效抗反转录病毒治疗(HAART)治疗过程中免疫重建炎性综合症IRIS发生的特点和治疗方法.方法对昆明医科大学第一附属医院感染性疾病科2009年以来收治的70例HIV/AIDS患者进行回顾性分析.结果 IRIS多发生在高效抗反转录病毒治疗(HAART)后1～3周以内,CD4+T淋巴细胞计数<50个/μL,治疗前多有机会性感染的患者.结论对于CD4+T淋巴细胞计数<50个/μL,特别是曾发生过机会性感染的患者进行HAART治疗时须住院观察3周.发生IRIS,准确判断病原很重要.及时,足量,有效的病原治疗是抢救治疗IRIS的关键.中毒症状重,伴有低氧血症者,可适当给予激素治疗,不必停止HARRT.

Analysis of Immune Reconstitution Inflammatory Syndrome in 15 HIV/AIDS Patients during HAART Treatment

Objective To study the characteristics and treatment methods of IRIS(immune reconstitution inflammatory syndrome)in HIV/AIDS HAART treatment process.Method 70 cases of HIV/AIDS patients who were admitted to our department since 2009 were analyzed retrospectively.Results IRIS occurred within 1 to 3 weeks after the HAART.For these patients,CD4+T lymphocyte counts were<50/μL.And most of them suffered from opportunistic infections before the HAART.Conclusions For patients,whom CD4+T lymphocyte count <50/ μL,especially suffer from opportunistic infections,must be hospitalized for observation of 3weeks when they were treated with HAART.It is important to accurately determine the pathogen for patients with IRIS.Timely,adequate and effective treatment of pathogens is the key for the treatment of IRIS.Symptoms of poisoning with heavy,hypoxemia,may be appropriate to give hormone treatment,and do not have to stop HARRT.