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目的 了解确山县抗艾滋病病毒(HIV)治疗过程中,接受治疗(治疗方案为齐多夫定胶囊、去羟基甘散和奈韦拉平片)的患者的免疫学和病毒学指标的变化和耐药毒株的出现情况。方法 对已开展抗HIV治疗的确山县部分接受治疗的HIV感染者进行了横断面调查(平均治疗时间为5 2个月) ,并在8个月后对该人群进行了随访,观察血浆病毒载量(VL)、CD+ 4 T淋巴细胞计数的变化以及耐药突变出现的情况。结果 ①8个月后VL低于检测限的病人的比例显著降低(横断面调查时为5 1 .1 %,随访时降为31 9%,P <0 . 0 5 ) ;②服药依从性<95 %的患者血浆VL显著升高(平均升高0 5 2log ,P <0 . 0 5 ) ,而CD+ 4 T淋巴细胞计数显著降低(平均降低96个/ μl,P <0 . 0 5 ) ;③随着治疗时间的延长耐药突变率由5 3 .7%上升到6 9. 8%。结论 应加强对病人的管理,提高服药依从性,降低耐药性的产生速度,保证治疗效果;及时对治疗病人进行耐药性监测,防止耐药毒株的传播。
Objective To understand the changes of immunological and virological characteristics of patients treated with HIV (treatment with zidovudine capsules, hydroxygalacturonase and nevirapine tablets) and drug-resistant toxin The emergence of strains. Methods Cross-sectional surveys were performed on a subset of HIV-infected HIV-positive patients in definite mountain counties treated with HIV (mean duration of treatment was 52 months). The population was followed up after 8 months to observe plasma viral load Volume (VL), changes in CD + 4 T lymphocyte counts, and the presence of drug-resistant mutations. Results ① After 8 months, the proportion of patients with VL lower than the detection limit was significantly lower (51.1% in the cross-sectional survey and 31 9% at the follow-up, P <0.05) % Of patients had significantly higher plasma VL (mean increase 0.525log, P <0.05), while CD + 4 T lymphocyte count was significantly lower (average 96 / l, P <0.05); With the extension of treatment time, the mutation rate of drug resistance increased from 53.7% to 69.8%. Conclusion The management of the patients should be strengthened, the medication compliance should be improved, the speed of drug resistance should be reduced and the treatment effect should be guaranteed. The drug resistance of patients should be monitored in time to prevent the spread of drug-resistant strains.