高效抗逆转录病毒治疗15例人类免疫缺陷病毒感染者一年总结

目的 首次报道我国于1999年5月开始对人类免疫缺陷病毒（HIV）－1感染者的规范化高效抗逆转录病毒治疗。方法 用齐多夫定＋拉米夫定（AZT＋3TC,商品名：双汰芝）联合硫酸茚地那韦（indinavir,商品名：佳息患）对15例HIV感染或艾滋病患者进行为期1年的治疗。随访指标为病毒载量和T淋巴细胞亚群分析。结果 15例随访1年,用药3个月后HIV－1 RNA平均值至198拷贝／ml,比治疗前的90743RNA拷贝／ml下降2.7log。用药后12个月CD4细胞计数平均增加67个／μl,CD8细胞计数平均减少192个／μl,CD4／CD8比例从0．35增加到0．56,15例中2例未作T淋巴细胞亚群分类,13例治疗后3、6、9、12个月CD4^ 童贞细胞（CD45RA＋CD62L＋）数呈现平稳上升趋势,在治疗1年时平均升高42个／μl。而CD8^ 童贞细胞（CD45RA＋CD62L＋）数平均升高19个/μl。所有患者用药后出现消化道反应,3例出现一过性黄疸,2例出现泌尿系结石。结论 与国外临床报道的治疗效果相一致,15例HIV－1不同阶段感染者经治疗后病毒载量水平明显降低,CD4平均细胞数有所增加,在具有不同病毒基因亚型的病例显示同样的治疗效果。

A clinical trial using zidovudine and lamivudine plus indinavir triple therapy in Chinese individuals with human immunodeficiency virus infection

OBJECTIVE: Evaluation of high active antiretroviral therapy (HAART) in human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) patients receiving combined antiretroviral therapy in China. METHODS: We initiated the first efficacy trial of zidovudine (AZT) 600 mg/d and lamivudine (3TC) 300 mg/d (brand name: Combivir) plus indinavir (2 400 mg/d) in 15 Chinese chronically infected with HIV in May 1999 at Beijing. RESULTS: There was a rapid reduction of 2.7 log in the plasma viremia levels in 15 cases 3 months, after treatment, from a mean baseline of 90 743 copies/ml. The mean CD(4) cell counts increased by 67 cells/microliter from a baseline mean value of 471 cells/microliter and the mean CD(8) cell counts reduced by 192/microliter after 12 months of therapy. The ratio of CD(4)/CD(8) increased from 0.35 to 0.56. The average naive CD(4) cell (CD(45)RA + CD(62)L +) count and naive CD(8) cell (CD(45)RA + CD(62)L +) count increased 42 and 19/microliter respectively after one-year treatment. This drug regimen was well tolerated, with mild nausea in all, transient elevated serum bilirubin in three and kidney stone in two patients. CONCLUSION: It is effective for the virus with different genotype. The results will form a scientific foundation for the development of therapeutic strategies for HIV infection in China.