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目的探讨高效抗逆转录病毒治疗(HAART)对AIDS患者的疗效及毒副作用。方法45例未经治疗的AIDS病人按基线CD4+ T细胞计数分为两组,予12个月HAART,分别在基线及治疗1、3、6、9、12个月末随访血浆病毒载量(VL)、T细胞亚群和临床症状。结果抗病毒治疗12个月后45例病人血浆VL平均下降2．8 lg拷贝／mL;CD4+ T细胞平均增长187个／μl,其中记忆表型增长119个／μl,纯真表型增长68个／μl,CD4+CD28+细胞比例显著升高;CD8+ T激活亚群比例显著降低。基线CD4+ T细胞计数>100个／μl的14例病人治疗12个月后有10例血浆VL<50拷贝／ml,而<100个／μl的31例病人治疗后仅有11例血浆VL<50拷贝／ml(P<0．05)。出现血浆波动的病例数在两组也有统计学差异(分别为2例和14例,P<0．05)。CD4+ T细胞计数呈双相增长过程,其增量与血浆VL减少量呈显著正相关。常见的药物副作用有消化道反应、外周神经炎、肝功能损害等。结论HAART方案对AIDS病人有较好的疗效,能够实现免疫重建,但也存在较多毒副作用。
Objective To investigate the curative effect and side effects of HAART on AIDS patients. Methods 45 cases of untreated AIDS patients were divided into two groups according to the baseline CD4 + T cell count. The HAART for 12 months was followed up at the end of baseline, 1,3,6,9,12 months of treatment, , T cell subsets and clinical symptoms. Results After 12 months of antiviral therapy, the plasma VL of 45 patients decreased by an average of 2.8 lg copies / mL; the average number of CD4 + T cells increased by 187 cells / μl, of which the memory phenotype increased by 119 cells / μl and the pure phenotype increased by 68 cells / μl, the proportion of CD4 + CD28 + cells was significantly increased; the proportion of CD8 + T activation subpopulations was significantly reduced. Of the 14 patients with baseline CD4 + T cell counts> 100 / μl, 10 had plasma VL <50 copies / ml after 12 months of treatment, whereas only 11 of <31 patients with <100 cells / μl had VL <50 Copy / ml (P <0.05). There were also statistically significant differences in plasma fluctuations between the two groups (2 and 14, respectively, P <0.05). CD4 + T cell count showed a biphasic increase process, and its increment was significantly and positively correlated with the decrease of plasma VL. Common side effects of drugs are gastrointestinal reactions, peripheral neuritis, liver damage and so on. Conclusions The HAART regimen has a good curative effect on AIDS patients and can achieve immune reconstitution, but there are also many side effects.