| 李宏,王哲,崔为国,梁妍,辛天义,李洁.艾滋病感染者抗病毒治疗的服药依从性及其相关因素的研究[J].Chinese journal of Epidemiology,2005,26(7):507-510 |
| 艾滋病感染者抗病毒治疗的服药依从性及其相关因素的研究 |
| Study on adherence and interrelated factors of acquired immunedef iciency syndrome patients receiving antiretroviral treatment |
| Received:August 25, 2004 |
| DOI： |
| KeyWord: 艾滋病病毒 抗病毒治疗 耐药性 |
| English Key Word: Human immunodeficiency virus Antiretroviral therapy Drug resistance |
| FundProject: |
| Author Name | Affiliation | | LI Hong | 河南省疾病预防控制中心性病艾滋病研究所, 郑州 450003 | | WANG Zhe | Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450003, China | | CUI Wei-guo | Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450003, China | | LIANG Yan | Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450003, China | | XIN Tian-yi | 沈丘县疾病预防控制中心, 郑州 450003 | | LI Jie | Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450003, China |
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| Abstract: |
| 目的了解河南省艾滋病病毒感染者/艾滋病患者(HIV/AIDS)高效联合抗病毒疗法(HAART)的服药依从性及其相关因素。方法抽取了2个AIDS综合防治示范区、1个AIDS高发县。未服药和服药在2-12个月的HIV感染者作为被调查对象,分别对服药依从性、不良反应及临床表现,治疗前后临床症状改善状况及治疗保障措施等项目,通过访谈问卷调查;同时抽取静脉血,测定评价服药者CD4+T淋巴细胞,病毒载量,用逆转录聚合酶链反应(RT-PCR)方法扩增HIV-1POL区基因,进行基因型耐药性分析。结果治疗组治疗时间在4-8个月的人数最多占78.24%,服药依从性达到90%～100%的占67.51%,停服和漏服药物的主要原因是不良反应占66.95%,最显著的不良反应是服药后引起的恶心、呕吐、皮疹等不适。治疗组坚持服药症状明显改善的占87.57%,停服和漏服药症状未明显改善的占11.01%。服药依从性对病情趋势变化具有显著影响(P<0.05)。治疗组服药后CD4+T细胞总数保持稳定或有所增加,但实际速度较缓慢。抗病毒治疗3个月和6个月时,患者的病情好转率分别是55.1%和50.8%,CD4+T细胞数较未服药治疗的患者显著提高。耐药性毒株的流行率显著增加,由未服药人群的13.9%快速上升到服药3个月的45.4%和服药6个月的62.7%,其中对非核苷类逆转录酶抑制剂(NNRTI)类药物耐药性的增加最为明显,导致中高度以上耐药率的显著增加。结论 |
| English Abstract: |
| Objective To study on the compliance antiretroviral(ARV) drugs and interrelated factors of HIV/AIDS patients undertaking highly active antiretroviral therapy( HAART) to improve clinical treatment. Methods 3 counties in Henan province were selected including 2 counties from China Cares Program points and one county where HIV/AIDS was serious. All cases studied had already received antiretroviral therapy(ART) for 2-12 months. Several indicators through uestionnaire were studied including drug adherence, side effect, symptoms status before and after treatment and ART measures etc.At the same time, blood was collected to analyze CD+4 T-lymphocyte, the virus loads of HIV and drug genotype resistance by reverse transcription-polymerase chain reaction (RT-PCR). Results In the therapy group, most patients had taken ARV drugs for 4-8 months, which accounted for 78.24% of the total number, with the adherence rate bove 90% as 67.51%. The main reason for the patients not listening to their doctor’s advice was due to ART drug’s side effects(66.95%), including queasiness, vomiting and tetter. In the therapy group, 82.57% of patients’symptoms were obvious. Adherence had a great impacton the improvement(P<0.05). After therapy, the total count of patients’CD+4 T-lymphocyte’s kept stable or improved with slow speed. At the time of 3 months and 6 months after ART, the rates of improvement were 55.1% and 50.8%. However CD+4 count did not show much difference between the twe group . The prevalence rate of HIV drug resistance strain roise from 13.9% in non-remedial group to 45.4% at the time of 3 months after therapy and 62.7% at the time of 6 months after therapy. The resistance against non-nucleoside reverse transcriptase inhibitors(NNRTI)had improved bviously. Conclusion Patients with HIV/AIDS receiving HAART, compliance seemed directly affect the curative effect and the implementation of therapy schedule and should be improved to avoid drug resistance. |
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