【摘要】 目的评估中国艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人),接受二线高效抗反转录病毒治疗(HARRT)3年的疗效评价。方法对2010年1月至2016年12月在中国医科大学附属第一医院,接受一线HAART失败的转入二线HAART的89例HIV/AIDS病人进行随访,评估HAART后3年的病毒学和免疫学疗效及临床结局。结果 89例HIV/AIDS病人中位年龄37岁;男性88例,占98.88%;男男性行为途径感染69例,占77.53%;接受二线HAART中位时间为30个月。二线治疗基线时HIV病毒载量中位值为4.51Log,治疗后6、12、24和36个月,HIV病毒载量<50拷贝/mL的比例分别为69.74%、79.41%、93.62%和92.59%,HIV病毒载量<400拷贝/mL的比例分别为92.11%、95.59%、95.74%和96.30%。二线基线CD4~+T淋巴细胞(简称CD4细胞)计数为(167.18±144.93)个/μ>L,治疗后6、12、24和36个月CD4~+T淋巴细胞计数增加至(276.27±143.66)个/μL、(329.47±151.05)个/μL、(420.71±145.27)个/μL和(531.27±209.32)个/μL,上述各个时间点的CD4细胞计数与治疗前基线比较差异均有统计学意义(P<0.001)。研究随访结束时,仅1例病人发生病毒学失败,4例发生低病毒血症。结论一线治疗失败病人更换以克力芝为基础的二线HAART方案,可获得良好的长期持续病毒应答和免疫重建,在保证服药依从性基础上,不容易发生二线治疗失败。更多还原

【Abstract】 Objective To evaluate the long-term virologic and immunologic outcomes of second-line ART among HIV/AIDS patients in China. Methods We conducted a retrospective analysis of HIV/AIDS patients,who failed in first-line ART and switched to second-line ART from January 2010 to December 2015,during which 89 AIDS patients initiated second-line ART regimens more than 6 months,and virologic and immunologic data were analyzed. Results Of 89 patients, the median age was 37 years, and 98. 88% were male. Mean CD4 + T cell and median HIV-1 RNA at second-line ART initiation were 167 cells/μL and 4.51 log, respectively. At 6, 12, 24, and 36 months of second-line ART, 69. 74%, 79.41%, 93.62% and 92.59 % of the patients achieved HIV-1 RNA<50 copies/mL and 92. 11%,95. 59%,95. 74% and 96. 30 % of the patients achieved HIV-1 RN A<400 copies/mL, and mean CD4 + T cell were 276. 27,329. 47, 420. 71, and 531. 27cells/μL respectively. At the end of the study,only one patient experienced in virological failure. Conclusion Our study demonstrates good virologic and immunologic outcomes of the PI/r based second-line ART in China.Majority of AIDS patients have achieved sustained virological response over 36 months. The findings highlight the need to improve adherence.更多还原