珠海市艾滋病患者高效抗逆转录病毒治疗免疫学效果及影响因素分析

目的 了解珠海市艾滋病患者高效抗逆转录病毒治疗免疫学效果及影响因素。 方法 采用回顾性调查方法,选取2005-2014年珠海市所有初次接受艾滋病高效抗逆转录病毒治疗满半年且治疗前和治疗后均接受了CD4⁺T淋巴细胞计数检测的患者为研究对象,以CD4⁺T淋巴细胞计数作为抗病毒治疗效果评价依据,采用多因素logistic回归分析探索艾滋病抗病毒治疗免疫学效果的影响因素。 结果 309例患者中,抗病毒治疗免疫学有效个案265例,有效率85.8%。治疗后患者CD4⁺T淋巴细胞计数(309.74±175.42)较治疗前(165.67±108.36)明显升高(t=20.13, P＜0.01)。多因素logistic回归分析结果显示,临床Ⅰ期(OR=7.755)、Ⅱ期(OR=18.338)、临床Ⅲ期(OR=1.369)患者的免疫学有效率较临床Ⅳ期临床期患者显著增高。服药依从性好的患者的免疫学有效率明显高于依从性差的(OR=3.741,P＜0.05)。 结论 珠海市艾滋病抗病毒治疗效果明显,患者疾病临床分期和服药依从性是珠海市艾滋病抗病毒治疗免疫学效果的主要影响因素,临床分期处于早期和服药依从性好有利于获得好的抗病毒治疗免疫学效果。通过早发现早治疗以及提高患者服药依从性有利于进一步提升珠海市艾滋病抗病毒治疗的效果。

Immunological effect of highly active anti-retroviral therapy and its influencing factors among AIDS patients in Zhuhai City

Objective To investigate the immunological effect of highly active anti-retroviral therapy (HAART) on AIDS and its influencing factors in Zhuhai City. Methods Retrospective survey method was used in this study. We selected all AIDS patients who had received initial HAART for at least half a year and accepted the detection of CD4⁺T lymphocyte count before and after receiving HAART in Zhuhai City during 2005-2014 to serve as the research objects. The immunological effect of HAART was evaluated on the basis of the count of CD4⁺T lymphocytes. Multifactor logistic regression analysis was performed to identify factors afffecting the effect of HARRT. Results There were 265 cases with effective HAART among 309 surveyed AIDS patients, with the effective rate being 85.8%. The amount of CD4⁺T lymphocytes in the AIDS patients after the treatment was significantly increased as compared with that before the treatment ((309.74±175.42)vs. (165.67±108.36), t=20.13, P<0.01). The Results of multifactor logistic regression analysis showed that the effective rate of immunological responses to HAART was significantly higher in the cases in clinical stages Ⅰ (OR=7.755), Ⅱ (OR=18.338) and Ⅲ (OR=1.369) than in the cases in clinical stage Ⅳ as well as higher in the cases with good medicine compliance than in the cases with poor medicine adherence (OR=3.741). Conclusions The therapeutic effect of HAART among the AIDS patients in Zhuhai City is obvious. The patients' clinical stages and medicine compliance are the leading factors influencing the therapeutic effect. Early clinical stages and good medicine compliance are conducive to acquiring satisfactory immunological effect of treatment. The Results suggest that early detection, early treatment and good medicine compliance are beneficial to further improving therapeutic effect of HAART on AIDS in Zhuhai City.