我国部分地区未治疗HIV感染人群的病毒载量趋势分析

目的了解中国艾滋病病毒（HIV）感染者体内病毒载量状况,及病毒载量与临床指征之间的相互关系;为中国艾滋病的预防和抗病毒研究提供基础数据。方法回顾性分析中国2003-2005年间检测的HIV感染者的病毒载量和CD4计数等数据,用SAS9.1进行统计分析,非参数检验。结果中国未治疗的HIV感染人群其病毒载量的最大浓度区域,2005年为10^4-10^5拷贝/ml,浓度从2003年的11.2%,2004年19.7%上升到2005年33.6%。中国未治疗的HIV感染人群的病毒载量随着CD4数的升高而减小,病毒载量的中位数,CD4〈200时为5.16lg/ml,CD4〉500时为2.77lg/ml（P〈0.0001）。未治疗组男性病人的病毒载量中位数为4.52lg/ml,高于女性的3.84lg/ml（P〈0.0005）,差异有统计学意义。结论病毒载量是监测HIV感染者的病程,评估抗病毒治疗的重要指标。中国未治疗的HIV感染人群的病毒载量呈现逐年上升的趋势,应尽早开展抗病毒治疗。

The trend of viral load in untreated HIV infectors in some regions of China

Objective To study HIV-1 plasma viral load（VL）status in HIV-1 infectors and correlation between VL and clinical markers. Methods Plasma viral load and CD4^＋ T count of HIV-1 infected subjects tested in 2003 - 2005 were retrospectively analyzed.Results In 2003 11.2% of untreated HIV-1 subjects had viral load ranging 104 - 105 copies/ML, while in 2004 and 2005 the percentage of untreated subjects having such viral load range increased to 19.7 % and 33.6% , respectively. As for HIV-1 infected people receiving antiretroviral drug treatment, 55.6% and 59.8% of them had viral load less than 1000 copies/ml in 2004 and 2005, respectively. An inverse correlation was observed between plasma viral load and CD4^＋ T-cell count among untreated HIV-1 subjects; i.e.viral loads decreased with rising CD4^＋ count. The median viral load was 5. 161g/ml when CD4^ ＋ count was less than 200/ul, and dropped to 2. 771g/ml when CD4^ ＋ count was higher than 500/ul（P〈0. 0001） ;the difference had statistical significance. The median viral load of untreated male subjects was significantly higher than female ones（4. 521g/ml in male vs 3. 841g/ml in female, P〈0. 0005） . Conclusion Viral load and CD4^＋ T-cell count are useful indicators for evaluating AIDS prognosis and antiviral treatment in HIV-1 infectors. Viral load tends to increase year by year among untreated HIV infectors in China and so antiretroviral therapy should be provided for them as early as possible.