摘要
目的观察高效抗逆转录病毒疗法(HAART)治疗HIV感染和艾滋病(AIDS)患者的疗效和副作用。方法8例HIV感染和AIDS患者CD4+T细胞计数基线水平范围为1×106/L^443×106/L,均值231×106/L,HIV鄄1病毒载量为3.66log~>5.70log拷贝/mL。接受茚地那韦(indinavir)加双汰芝(combivir,含齐多夫定和拉米夫定)治疗12个月,每月用流式细胞仪MultiSET绝对计数法检测患者CD4+T细胞水平,bDNA法(检测范围1.70log^5.70logRNA拷贝/mL)检测血浆HIV鄄1病毒载量1次,并对患者进行严密的临床观察。结果治疗后12个月CD4+T细胞计数平均升高267×106/L(P<0.01)。病毒载量于治疗后1~4个月全部降至可测水平(1.70log拷贝/mL)以下,平均下降2.13log拷贝/mL。1例患者有过1次因漏服药物所致的小幅度且短暂的病毒载量反弹,其他患者的病毒载量均维持在可测水平之下或仅在可测的水平。1例晚期艾滋病患者(CD4+T细胞基线水平为1×106/L)的卡氏肺孢子虫肺炎和皮肤真菌感染消失,临床症状明显改善,恢复正常工作。其他患者也见临床好转。药物副作用有:8例患者中有早期胃肠道反应6例,一过性白细胞减少3例,轻度贫血2例,血淀粉酶升高2例,血总胆红素升高4例,血糖升高1例。无药物相关的心、肝、肾功能损害,亦无肾结石和胰腺炎的表现。
Objective To evaluate the clinical efficacy and side-effects of highly active antiretroviral therapy(HAART)in patients infected with HIV-1and AIDS.Methods Eight HIV/AIDS patients were enrolled in the study and the mean baseline CD4 + T cell count(231×10 6 /L;range1~443×10 6 cells/L)and mean HIV-1viral load(3.66~>5.70log copies/mL)were determined.All patients received a treatment regimen consisting of indinavir plus combivir(AZT+3TC)for12months.During the treatment,changes in CD4 + T cell counts were monitored using a MultiSET flow cytometric assay while changes in HIV-1viral load were determined by bDNA method(range of detection1.70~5.70log RNA copies/mL).The treatment-related adverse events were clinically evaluated.Results Twelve months after the initiation of HAART,CD4 + T cell counts increased by a mean of267×10 6 cells/L(P<0.01).In the first four months,HIV-1viral load declined to detectable level(below1.70log copies/ml)in all patients,with a mean decrease of2.13log copies/mL.One patient experienced a single,transient rebound of viremia that was related to a missed dosing.In the other patients,HIV-1viral load was consistently below,or near to the threshold of detection.A patient with advanced AIDS(CD4 + T cell count at baseline of1×10 6 cells/L)experienced a resolution of Pneumocystis carinii pneumonia(PCP)and skin fungal infection and was able to return to work.Several other patients also experienced clinical improvement.Treatment-related adverse events were observed in eight patients,including gastroenteric discomfort during the early period of treatment(n=6),transient leukocytopenia(n=3),mild anemia(n=2),increased level of blood amylase(n=2),increased level of total bilirubin(n=4)and increased level of blood glucose(n=1).Functional impairment of heart,liver or kidneys related to the treatment was not observed,nor was there any incidence of kidney stone or pancreatitis.Conclusions Treatment of indinavir combined with combivir was safe and well tolerated in all eight patients,with improved clinical,virological and immunological parameters.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2003年第7期387-390,共4页
Chinese Journal of Dermatology
