【作者】 张静； 林彬； 林琳； 杨培菊； 傅继华； 李韩平； 李敬云； 于修平；

【Author】 Zhang Jing, Lin Bin, Lin Lin, et al. Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China

【机构】 山东省疾病预防控制中心艾滋病防治所； 军事医学科学院微生物流行病研究所； 山东大学医学院；

【摘要】 目的了解山东省艾滋病患者高效联合抗病毒治疗(HAART)效果和病人中HIV-1耐药毒株的出现情况及其对治疗产生的影响。方法于2004、2005年分别对治疗和未接受抗病毒治疗的HIV感染人群进行2次横断面调查。对接受调查者经知情同意,进行个人访谈填写耐药性研究调查表并进行免疫学、病毒学实验室指标评价和服药依从性调查;测定CD+4T淋巴细胞计数、血浆病毒载量(VL);用RT-PCR方法扩增 HIV-POL区基因,进行基因型耐药性分析。结果正在接受治疗的艾滋病患者31例,未治疗的27例,两年内, 分别有83．3％、64．5％的治疗病人CD+4T淋巴细胞计数达到350个／微升以上,分别有45．8％、45．2％的治疗病人的病毒载量达到检测限以下,与未治疗组有显著差异。治疗组出现7个耐药位点,未治疗组出现4个耐药位点,高度耐药突变率及总耐药性突变率前者远高于后者。结论抗病毒治疗患者大部分达到了病毒抑制和免疫重建的目的,AIDS症状得到明显好转,治疗病人中出现HIV耐药性毒株,但对总体治疗效果影响不大。更多还原

【Abstract】 Objective To understand the effect of highly active antiretroviral therapy (HAART) on AIDS patients, and explore the prevalence and the impact of HIV- 1 drug resistance in Shandong province. Methods To make 2 times cross - sectional investigations in 2004 and 2005 respectively on the clinical symptom and the drug compliance of the AIDS patients with HAART or not by questionnaire according to the principle of informed consent, then estimate immunology , virology and laboratory index for them, and analyze the HIV ?1 drug genotype resistance by sequencing the gene of HIV - POL after RT - PCR. Results 31 AIDS cases with HAART and 27 AIDS cases without HAART were investigated. 83. 3 % of the AIDS patients with HAART in first (2004) investigation got the rising CD + 4 T cell counting over 350/μl, and 64.5% in second (2005) investigation; Respectively 45.8 % and 45.2 % of the AIDS patients with HAART in 2 years got the decreasing HIV load under the detected limit with the remarkable difference compared with the AIDS without HAART. 7 drug resistance gene sites were found in AIDS patients with HAART and 4 in AIDS patients without HAART, the high degree drug resistance mutation rate and total drug resistance mutation rate of the former were higher remarkably than those of the latter. Conclusion Most of the AIDS patients with HAART got to the purpose of immunity rebuilding and HIV control, and their symptoms got better. The drug resistance stain appeared in Shandong, but had little effect on the HAART.更多还原