抗逆转录病毒药物治疗8例获得性免疫缺陷综合征1年的疗效

目的:观察国产去羟肌苷散、司他夫定和奈韦拉平联合治疗获得性免疫缺陷综合征(艾滋病)病人1a的初步疗效、不良反应以及耐药性突变位点。方法:艾滋病病人8例,给予去羟肌苷、司他夫定和奈韦拉平3药联合治疗,在治疗前和治疗1,3,6,9,12mo时定期监测病人的血浆病毒载量及CD4+T淋巴细胞计数,评价药物不良反应,并对基线及治疗1a的标本进行基因型耐药性检测。结果:治疗后病人血浆中病毒载量均明显降低(P<0.01),CD4+T淋巴细胞数量增加(P<0.01)。早期的药物不良反应较少,当治疗1a后至少有2例病人对治疗药物产生了耐药性。结论:国产3药联合治疗在早期就能有效抑制艾滋病病毒的复制,机体免疫功能也有改善,耐受性良好,后期则可以发生耐药性变异。

Clinical efficacy in 8 acquired immunodeficiency syndrome patients treated with antiretroviral drugs

AIM:To observe the efficacy,adverse reactions and drug-resistant mutations of antiretroviral therapy with domestic drugs in acquired immunodeficiency syndrome(AIDS)patients.METHODS:Eight AIDS patients were treated with didanosine,stavudine and nevirapine combined therapy.All patients were followed up for 12 months with measurements of plasma HIV-1 RNA level and CD4 T cell count of the patients at baseline and the ends of the 1st,3rd,6th,9th and 12th month;together with record of adverse reactions.Genotype resistance assays were performed for 12th month specimens.RESULTS:The level of plasma HIV-1 RNA decreased and CD4 cell count increased significantly in each of 8 patients,while the adverse reactions of the three drugs were mild in the early stage.Drug resistance mutations emerged in two patients after one year therapy.CONCLUSION:The regimen with combined three domestic drugs could suppress HIV reproduction and improve immunological function with well toleration in the earlier period,but resistance mutations lead to rebound of viral load.