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目的研究吉林市93例HIV感染者/AIDS病人疾病进展情况;采用高效抗逆转录病毒治疗(HAART)的疗效,为HIV/AIDS综合防治措施提供科学依据。方法通过现场流行病学调查分析HIV感染者/AIDS病人一般情况,检测抗丙型肝炎病毒(HCV)抗体,定期进行CD4+、CD8+T淋巴细胞绝对计数检测以监测疾病进展,用HAART治疗HIV感染者/AIDS病人,监测病毒学及免疫学变化,观察抗病毒药物的毒副作用及服药依从性。结果吉林市93例HIV感染者/AIDS病人中86例(92.5%)经血液感染且合并HCV感染。估计感染时间在8年以上者88例,其中20.5%CD4+T淋巴细胞数<200/mm3,50%为200~500/mm3,29.5%>500/mm3。接受HAART治疗的23例HIV感染者/AIDS病人治疗前平均病毒载量为5.06 log拷贝/ml(4.39×105拷贝/ml),治疗12个月后平均下降3.47log拷贝/ml(P<0.001),其中16例达到检测不出的水平(<400拷贝/ml),CD4+T淋巴细胞数平均上升48个/mm3(P<0.05)。结论吉林市存在部分疾病进展缓慢的HIV感染者;HAART治疗取得了较好的疗效,但司他夫定和去羟肌苷联合应用使周围神经病变发生率较高;加强对感染者疾病进展和抗病毒疗效及不良反应监测,有助于确定开始抗病毒治疗的时机和及时调整治疗方案。
Objective To study the disease progression of 93 HIV / AIDS patients in Jilin City and to provide a scientific basis for the comprehensive prevention and treatment of HIV / AIDS by using highly effective antiretroviral therapy (HAART). Methods The prevalence of HIV / AIDS patients was analyzed by on-site epidemiological investigation. Anti-HCV antibodies were detected. CD4 +, CD8 + T lymphocyte count was monitored regularly to monitor disease progression. HAART was used to treat HIV infection / AIDS patients to monitor virological and immunological changes to observe the side effects of antiviral drugs and medication compliance. Results Of the 93 HIV / AIDS patients in Jilin City, 86 (92.5%) were infected with blood and had HCV infection. 88 cases were estimated to be infected more than 8 years, 20.5% CD4 + T lymphocytes <200 / mm3, 50% 200 ~ 500 / mm3, 29.5%> 500 / mm3. The average viral load of 23 HIV-infected / AIDS patients treated with HAART was 5.06 log copies / ml (4.39 105 copies / ml) before treatment, with an average decrease of 3.47 log copies / ml after 12 months of treatment (P <0.001) 16 of them reached undetectable levels (<400 copies / ml) and the average number of CD4 + T lymphocytes increased by 48 / mm3 (P <0.05). Conclusions There are some HIV-infected persons with slow progression of disease in Jilin City. HAART treatment has achieved good effect, but the combination of stavudine and didanosine causes a higher incidence of peripheral neuropathy. Antiviral efficacy and adverse reaction monitoring help to determine the timing of starting antiviral therapy and timely adjustment of treatment options.