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目的观察核苷类反转录酶抑制剂(NRTI)+蛋白酶抑制剂(PI)方案,对免疫重建不良的艾滋病(AIDS)病人免疫功能的影响。方法接受一线抗病毒治疗1年以上、病毒载量低于检测下限(<50拷贝/mL)且免疫学失败的病人,改用NRTI+PI方案,即用拉米夫定(3TC)、替诺福韦酯(TDF)+洛匹那韦/利托那韦(LPV/r)治疗12个月,检测治疗期间病人CD+4T淋巴细胞(CD4细胞)数的变化。结果收集的16例病毒载量<50拷贝/mL且免疫学失败的病人,在接受治疗3、6和12个月后,病人CD4细胞数分别上升至(195±5.63)个/μL、(213±4.68)个/μL和(270±4.36)个/μL,显著高于基线(换药时)CD4细胞水平(131±3.65个/μL)(P<0.01)。结论 3TC+TDF+LPV/r方案可以促进病毒载量低而免疫功能低下的病人的免疫重建。
Objective To observe the effect of nucleoside reverse transcriptase inhibitor (NRTI) + protease inhibitor (PI) on the immune function of immunocompromised AIDS patients. Methods Patients receiving first-line antiviral therapy for more than 1 year and whose viral load was below the lower limit of detection (<50 copies / mL) and immunologically failed were switched to NRTI + PI regimen with lamivudine (3TC) Fufang ester (TDF) + lopinavir / ritonavir (LPV / r) for 12 months, the number of CD + 4T lymphocytes (CD4 cells) in patients during treatment was measured. Results In 16 patients with viral load <50 copies / mL and immunological failure, the CD4 cell counts increased to (195 ± 5.63) / μL, respectively, at 3, 6 and 12 months after treatment ± 4.68) / μL and (270 ± 4.36) / μL, significantly higher than the baseline CD4 cell level (131 ± 3.65 / μL) (P <0.01) at baseline. Conclusions The 3TC + TDF + LPV / r regimen can promote immune reconstitution in patients with low viral load and immunocompromised patients.