300例艾滋病患者高效抗逆转录病毒治疗后免疫重建规律探讨

目的探讨高效抗逆转录病毒治疗（HAART）对中国南部地区艾滋病患者的免疫重建规律。方法收集近3年来300例患者的完整资料，按基线CD4^＋T细胞数分为A、B、C三组，观察基线及治疗1、3、6、12月末CD4^＋T淋巴细胞数、12月末血浆病毒载量（VL）、临床症状和毒副作用。结果抗病毒治疗12月末300例患者CD4^＋T淋巴细胞计数平均上升127个／1，以治疗3月后增长明显，3、12月末与基线CD4^＋T淋巴细胞计数比较差异有显著性（P〈0．05）；12月末273例（91％）患者血浆病毒载量（VL）〈5copies/ml，27例（9％）患者病毒载量（VL）〉50copies/ml，高病毒载量A组16例，C组4例；A组与C组比较差异有显著性（P〈0．05）；药物不良反应主要是外周神经炎（35．4％）、骨髓抑制（18．2％）、皮疹（15．2％）、肝功能损害（12．1％）、乳酸酸中毒（12．1％）和肾结石（6．1％）。结论HAART治疗对中国南部地区的艾滋病患者有效，能够实现免疫重建，但存在较多毒副作用。

The study of immunologic reconstitution in HIV/AIDS highly active antiretroviral therapy

Objective To observe the immunologic reconstitution in HIV/AIDS patients from the area of south China with highly active antiretroviral therapy(HAART).Methods 300 HIV/AIDS patients in recent three years were divided in to A、B、C three groups randomly according to baseline CD+4T cell counts.The counts of CD+4T cell were observed in patients at baseline and after 1,3,6 and 12 months of HAART,respectively,and plasma viral load (VL) was detected at the end 12 months,Clinical symptoms and drug side-effects were also observed.Results The counts of CD+4T were raised 127 cell/l in these 300 HIV/AIDS patients after 12 months with HAART.The rise in CD+4T cells was significant after HAART 3 months with.A significant increase in CD+4T cells was observed at 3 and 12 month after HAART compare to the baseline CD+4T cells counts (t=16.8、t=11.95,P＜0.05).After 12 months of treatment,plasma viral load was less than 50 copies/ml in 273 (91%) HIV/AIDS patients while viral load more than 50 copies/ml found in 27 cases.These were 16 cases with high viral load in group A and 4 cases in group C,Difference of the two groups was significant(χ2=4.37 P＜0.05).The main side-effects in HAART were neuropathy(35.4%),bone marrow depression(18.2%),rash(15.2%),liver function injury(12.1%),lactic acidosis(12.1%) and kidney calculi(6.1%).Conclusion Highly active antiretroviral therapy was effective in HIV/AIDS patients in the area of south China,and immunologic reconstitution achieved by highly active antiretroviral therapy with some side-effects observed.