AIDS/TB双重感染病人HAART过程中毒副作用的临床研究

目的观察获得性免疫缺陷综合征合并结核病病人（AIDS/TB）在高效抗反转录病毒治疗（HAART）过程中毒副作用的发生情况。方法对106例AIDS/TB病人进行随访,观察实施HAART后1年内毒副作用的发生情况及CD4＋T细胞计数上升水平,分析其发生毒副作用与基线CD4＋T细胞水平的相关性。结果 HAART 1年内106例患者中出现毒副作用症状39例,占36.8%,其中24例在HAART后3个月内出现,占61.5%,主要表现为食欲改变、恶心呕吐、四肢麻木。绝大多数病人在接受HAART后CD4＋T细胞均显著上升（P〈0.01）。基线CD4＋T细胞〈50/μl者72例,基线CD4＋T细胞≥50/μl者34例,两组HAART后毒副作用的发生率及CD4＋T细胞上升幅度比较差异无统计学意义（P〉0.05）。结论 AIDS/TB患者HAART后1年内毒副作用发生率较高,大多发生于HAART后3个月内毒副作用与基线CD4＋T细胞计数水平无明显相关性。

Clinical Observation for the Adverse Effects during Highly Active Antiretroviral Therapy in AIDS Patients with Tuberculosis

Objective To observe the adverse effects in AIDS patients with tuberculosis after highly active antiretroviral therapy（HAART）.Methods 106 patients with both AIDS and tuberculosis during first year HAART were followed up,the adverse effects and CD4＋T cell count were observed and the relationship between adverse effects and baseline levels of CD4＋T cell count were analyzed.Results 39（36.8%）patients suffered adverse effects during first year HAART in the study.And 24 patients suffered adverse effects for HAART three months later,the total rates of which were 61.5%.The main clinical features of adverse effects were lack of appetite,nausea,vomiting and limb numbness.The CD4＋T cell count of most patients increased after HAART（P0.01）.There were 72 patients with baseline levels of CD4＋T cell count50/μl and 34 patients with baseline levels of CD4＋T cell count ≥50/μl.The rates of adverse effects and the rising range of CD4＋T cell count did not show significant difference between the two groups after HAART（P0.05）.Conclusion The rates of adverse effects was 36.8% during first year HAART in AIDS patients with tuberculosis,most of which occur during HAART within three months.The adverse effect is not closely related to baseline levels of CD4＋T cell count.