【摘要】 目的 为探讨艾滋病高效抗逆转录病毒治疗、疗效观察及其对免疫功能的影响.方法 应用HAART疗法对4例有严重免疫功能低下的HIV/AIDS病人进行治疗.结果 所有病人在治疗4周HIV复制被明显抑制,血浆病毒载量平均下降1.99log/ml（0.73～2.46log/ml）,CD₈⁺、CD₄⁺细胞和血浆IL-2浓度在4～12周后持续性显著增高,上升幅度分别为67.2%,103.0%,255.1%,而血浆sIL-2R、IL-6、TNF-α、sTNFR-I、Neopterin浓度在治疗4～12周后持续下降至正常水平或以下.HAART治疗后各因素变化间的相关性分析显示,CD₄⁺细胞数与CD₈⁺、CD₃⁺细胞和血浆IL-2浓度之间,血浆病毒载量与sIL-2R、IL-6、TNF-α、sTNFR-I、Neopterin之间,sTNFR-I和Neopterin与sIL-2R、IL-6、TNF-α之间均存在明显正直线相关性;而CD₄⁺细胞数与血浆病毒载量、sIL-2R、sTNFR-I、Neopterin之间.以及IL-2和sIL-2R之间则有明显负直线相关性.结论 抗病毒治疗效果、病毒复制和免疫活化间具有密切关系,HAART治疗能快速有效地抑制HIV-1的复制,纠正机体免疫功能紊乱和重建免疫功能;外周血CD₄⁺细胞数、血浆病毒载量、IL-2、sIL-2R、TNF-α、sTNFR-I、Neopterin的浓度变化可以作为HAART治疗效果评价的重要指标.更多还原

【Abstract】 Objective To observe HAART treatment effectiveness to HIV/AIDS patients with severe immunodeficiency. Methods 4 asymptomatic or symptomatic patients infected HIV- 1 were treated with highly active antiretrovirus therapy( HAART), and the indicators of their immune function such as T lymphocyte subsets, plasma HIV load, etc. were evaluated. Results HIV replication was inhibited, and plasma HIV load was declined to an average of 1.99 log/ml (0.73 -2.46 log/ml) after the patients had been treated with HAART for 4 weeks, and CD8+ as well as CD4+ cell count and plasam IL-2 level were increased by 67.2%, 103.8%, 255.1%, respectively, after 4, 8, 12 weeks’ treatment. On the contrary, the levels of plasma sIL - 2R, IL - 6, TNF - a, sTNFR - I, Neopterin were significantly decreased after 4-12 weeks’ treatment of the patients. By regression analysis, the change of CD4+ cell count correlated significantly with simul-tanous change of CDg . So did CD3+ cell count with plasma IL - 2 level, plasma level of HIV load with sIL - 2R, IL - 6, TNF - a, sTNFR - I, Neopterin, as well as sTNFR - I and Neopterin with sIL - 2R, IL - 6 and TNF - a. A significant negative linear correlation was found between CD4+ cells count and HIV load, plasma levels of sIL - 2R, Neopterin, and IL - 2 and sIL- 2R. Conclusion The relationship is revealed between HIV replication immune activation and HAART an-tiveiral efficacy. HAART had a better effectiveness on inhibiting HIV replication, reversing immune function defects and reconstructing immune function. The changes of the indicators, IL - 2, sIL-2R, TNF - a, sTNFR - I, Neopterin, CD4+ cell count as well as plasma HIV load, can be selected as the important predictors for HAART to treat HIV/AIDS patients.更多还原