山东省部分艾滋病患者抗病毒治疗效果及耐药性研究

张静; 林彬; 林琳; 杨培菊; 傅继华; 李韩平; 李敬云

Abstract

张静,林彬,林琳,杨培菊,傅继华,李韩平,李敬云.山东省部分艾滋病患者抗病毒治疗效果及耐药性研究[J].Chinese journal of Epidemiology,2007,28(11):1108-1111

山东省部分艾滋病患者抗病毒治疗效果及耐药性研究

study on the effect of treatment and the status of drug resistance among HIv／AIDs patients treated withhighly actiVe antiretroViral therapy in Shandong province

Received:April 12, 2007

DOI：

KeyWord: 艾滋病耐药性高效抗逆转录病毒治疗

English Key Word: AIDS Drug resistance Highly active antiretroviral therapy

FundProject:

Author Name	Affiliation
ZHANG Jing	Shandong Provincial Center. for Disease Control and Prevention, Jinan 250014, China
LIN Bin	Shandong Provincial Center. for Disease Control and Prevention, Jinan 250014, China
LIN Lin	Shandong Provincial Center. for Disease Control and Prevention, Jinan 250014, China
YANG Pei-ju	Shandong Provincial Center. for Disease Control and Prevention, Jinan 250014, China
FU Ji-hua	Shandong Provincial Center. for Disease Control and Prevention, Jinan 250014, China
LI Han-ping	军事医学科学院微生物流行病研究所)
LI Jing-yun	军事医学科学院微生物流行病研究所)

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Abstract:

目的了解山东省艾滋病患者高效抗逆转录病毒治疗(HAART)效果和病例中HIv.1耐药毒株的出现情况及其对治疗产生的影响。方法于2004、2005年分别对治疗和未接受抗病毒治疗的HIV感染人群进行2次横断面调查。对接受调查者经知情同意，进行个人访谈填写耐药性研究调查表并进行免疫学、病毒学实验室指标评价和服药依从性调查；测定CD4+ T淋巴细胞计数、血浆病毒载量(VL)；用RT.PcR方法扩增HIV-POL区基因，进行基因型耐药性分析。结果正在接受治疗的艾滋病患者31例，未治疗的27例，2年内分别有83.3％、64.5％的治疗患者CD4+：T淋巴细胞计数>350个／弘1，分别有45.8％、45.2％的治疗患者VL达到检测限以下，与未治疗组的差异有统计学意义。治疗组患者中出现7个耐药位点，未治疗组出现4个耐药位点，高度耐药突变率及总耐药性突变率前者远高于后者。结论抗病毒治疗患者大部分达到了病毒抑制和免疫重建的目的，症状得到明显好转，治疗患者中出现HIV耐药性毒株，但对总体治疗效果影响不大。

English Abstract:

0bjectiVe To understand the effect of highly active antiretroviral therapy(HAART)onAIDS patients，and to explore the prevalence and the impact of HIV.1 drug resistance in Shandongprovince.methods 2 cross-sectional studies were carried on in 2004 and 2005，to coUect data on clinicalsymptoms and compliance of the AIDS patients with HAART through questionnaire. Informed-consentprinciple was followed to test。n immunological，viral and laboratory index of them. HIV一1 drug genotyperesistance by sequencing the gene of HIV-POL after RT-PCR was performed and analyzed. results 3 1AIDS cases with and 27 AIDS cases without HAART，were studied.83.3％and 64.5％of the AIDSpatients with HAART showed that the CD4+ T cell count was rising to over 350阻l，in the first study(2004)and in the second(2005)study respectively but still 45.8％and 45.2％of AIDS patients underHAART in the 2 yearS showed a decreasing HIV load under the detected limit.However，these findingswere showing remarkable difference when compared with the AIDS without HAART.7 drug resistancegene sites were found in AIDS patients with HAART and 4 in AIDS patients without HAART.The rate onhigh degree drug resistance mutation and total drug resistance rate of mutation of the former were higherremarkably than those of the latter.conclusion Most of the AIDS patients with HAART met the purposeof rebuilding immunity and control of HIV，as well as alleviation of symptoms.Although the drug resistancestain appeared in Shandong，but had 1ittle effect on HAART.

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