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目的了解山东省艾滋病患者高效抗逆转录病毒治疗(HAART)效果和病例中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_4~+T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,2年内分别有83.3%、64.5%的治疗患者CD_4~+T淋巴细胞计数>350个/μl,分别有45.8%、45.2%的治疗患者VL达到检测限以下,与未治疗组的差异有统计学意义。治疗组患者中出现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,症状得到明显好转,治疗患者中出现HIV耐药性毒株,但对总体治疗效果影响不大。
Objective To understand the effect of HAART and HIV-1 resistant strains in AIDS patients in Shandong Province and their impact on treatment. Methods In 2004 and 2005, two cross-sectional surveys were performed on HIV-infected and untreated HIV-infected individuals respectively. Respondents were interviewed informed consent, personal interviews filled out the drug resistance research questionnaire and immunology, virological laboratory evaluation of indicators and medication compliance; determination of CD_4 ~ + T lymphocyte count, plasma viral load (VL ); RT-PCR amplification of HIV-POL region gene for genotypic drug resistance analysis. Results 31 cases of AIDS patients under treatment, 27 cases untreated, respectively, 83.3% within 2 years, 64.5% of the patients treated with CD_4 ~ + T lymphocyte count> 350 / μl, respectively 45.8%, 45.2% of the treatment Patients VL reached below the detection limit, with no difference between the treatment group was statistically significant. There were 7 resistance sites in the treatment group, 4 resistance sites in the untreated group, the highly resistant mutation rate and the total resistance mutation rate were much higher than the latter. Conclusion Most patients with antiviral therapy achieve the goal of virus suppression and immune reconstitution, the symptoms are obviously improved, and HIV-resistant strains appear in the treated patients, but have little effect on the overall treatment effect.