【摘要】 目的评估中药在高效抗逆转录病毒治疗(HAART)间断过程中对CD4+T淋巴细胞和病毒载量的影响。方法采用齐多夫定/拉米夫定+依非韦伦方案,对19例HIV/AIDS患者进行HAART治疗,治疗6个月后停用HAART,换服中药2个月,而后再次启动HAART3个月,再次停用并服中药3个月,观察患者体内CD4+T淋巴细胞和病毒载量的变化情况。结果在第1次治疗间断过程中,换用中药1个月时有43.8%的患者未出现病毒反弹,62.6%的患者免疫功能稳定或上升;2个月时有18.8%的患者未出现病毒反弹,43.8%的患者免疫功能稳定或上升;两者的病毒载量变化差异无显著性(P=0.097),换用中药2个月时的CD4+T淋巴细胞计数较1个月时显著下降(P=0.043)。在第2次治疗间断过程中,换用中药1个月时有33.3%的患者未出现病毒反弹,64.3%的患者免疫功能稳定或上升;3个月时有13.3%的患者为出现病毒反弹,46.6%的患者免疫功能稳定或上升;两者的病毒载量变化差异有显著性(P=0.017)。治疗12个月时,患者体内的CD4+T细胞计数显著高于基线水平(P=0.014)。结论中药可在一定程度上抑制HAART间断时的病毒反弹,维持患者的免疫功能,该作用可随间断时间的延长而减弱。更多还原

【Abstract】 Objective To explore the impacts of traditional Chinese medicine(TCM)on CD4+T cell counts and human immunodeficiency virus(HIV)viral loads during the course of structured treatment interruption(STI)in highly active antiretroviral therapy(HAART).Methods Nineteen HIV/ADIS patients were treated for 14 months as follows:initiated with zidovudine/lamivudine+efavirdine for 6 months,then discontinued the therapy and treated with TCM instead for 2 months.HAART was then reinitiated for another 3 months,and then discontinued and replaced with TCM for another 3 months.The changes of CD4+T cell counts and HIV viral loads were measured.Results During the first STI of HAART,43.8% of patients had no viral rebounds one month later,and 62.6% had stable or increased immune functions;18.8% had no viral rebounds two months later,and 43.8% had stable or increased immune functions.Changes of viral loads were not significantly different between these two months(P=0.097),while CD4+T cell counts significantly decreased two months later compared with one month later(P=0.043).During the second STI of HAART,33.3% of patients had no viral rebounds one month later,and 64.3% had stable or increased immune functions;13.3% had no viral rebounds 3 months later and 46.6% had stable or increased immune functions.Changes of viral loads had significant difference(P=0.017),while CD4+T cell counts at month 12 elevated significantly compared with the baseline(P=0.014).Conclusions TCM can suppress the viral rebounds during STI-HAART,maintain immune functions.However,this effect may decrease along with the prolongation of STI-HAART.更多还原