高效抗反转录病毒治疗HIV感染者和AIDS患者发生不和谐反应的影响因素及改用洛匹那韦利托那韦的疗效研究
发布时间：2018-08-29 07:30
【摘要】：目的探讨高效抗反转录病毒治疗(HARRT)HIV感染者和AIDS患者发生不和谐反应的影响因素,并观察改用洛匹那韦利托那韦(LPV/r)的疗效。方法选取2006年7月—2013年3月在柳州市人民医院进行免费抗病毒治疗且跟踪随访的HIV感染者和AIDS患者510例为研究对象,经HARRT 12个月后,174例患者发生不和谐反应,其中70例同意更换为含LPV/r的二线治疗方案。收集患者一般资料,记录治疗时及治疗后3、6、12个月时HIV RNA、CD+4T细胞计数、CD+8T细胞计数、淋巴细胞计数、白细胞计数、血红蛋白、血小板计数,记录更换治疗方案者和未更换治疗方案者第2年CD+4T细胞计数的增长量。结果多因素Logistic回归分析显示年龄〔OR=1.037,95%CI(1.012,1.062),P=0.004〕、治疗时CD+4T细胞计数〔OR=0.988,95%CI(0.982,0.995),P0.001〕、治疗后3个月CD+4T细胞计数〔OR=0.991,95%CI(0.985,0.997),P=0.001〕、治疗后6个月CD+4T细胞计数〔OR=0.993,95%CI(0.988,0.998),P=0.009〕、治疗后6个月淋巴细胞计数〔OR=0.433,95%CI(0.230,0.816),P=0.010〕进入回归方程,是HIV感染者和AIDS患者发生不和谐反应的影响因素。未更换治疗方案患者CD+4T细胞计数增长70.5(119.5)个/μl,更换治疗方案患者CD+4T细胞计数增长147(155.2)个/μl,差异有统计学意义(Z=-5.386,P0.05)。未更换治疗方案患者不和谐反应发生率为53.8%(56/104),更换治疗方案患者为22.8%(16/70),不和谐反应率比较差异有统计学意义(χ2=11.413,P0.05)。结论年龄、治疗时CD+4T细胞计数等是HARRT患者发生不和谐反应的影响因素,且发生不和谐反应后改用含LPV/r的方案治疗,可改善患者免疫功能,降低不和谐反应发生率。
[Abstract]:Objective to investigate the influencing factors of discordant reaction between (HARRT) HIV infected patients and AIDS patients with highly effective antiretroviral therapy and to observe the efficacy of Lopinowilitonavir (LPV/r). Methods from July 2006 to March 2013, 510 cases of HIV infected persons and AIDS patients who were treated with free antiviral therapy in Liuzhou people's Hospital and followed up were selected as the subjects. 174 patients with HARRT 12 months later had disharmonious reaction. Seventy of them agreed to replace it with a second-line therapy with LPV/r. The general data of the patients were collected, and the HIV RNA,CD 4T cell count, CD8T cell count, lymphocyte count, white blood cell count, hemoglobin and platelet count were recorded at the time of treatment and at 12 months after treatment. The increase of CD 4 T cell count in the second year was recorded between the patients who changed the treatment regimen and those who did not. Results Multivariate Logistic regression analysis showed that age (OR=1.037,95%CI (1.012 卤1.062) / P 0.004), CD 4T cell count (OR=0.988,95%CI (0.9820.995) / P0.001), CD 4T cell count (OR=0.991,95%CI (0.9850.997) / P0. 001) and CD 4T cell count (OR=0.993,95%CI (0.9880.998) / P 0.009) at 6 months after treatment. The lymphocyte count (OR=0.433,95%CI (0.230 卤0.816) entered the regression equation 6 months after treatment, which was the influencing factor of disharmonious reaction between HIV infected patients and AIDS patients. The number of CD 4T cells increased by 70.5 (119.5) / 渭 l in patients with no replacement treatment regimen and 147( 155.2) / 渭 l by CD _ 4T cells in patients with replacement treatment regimen. The difference was statistically significant (P 0.05). The rate of disharmonious reaction was 53.8% (56 / 104) in patients without replacement treatment regimen and 22.8% (16 / 70) in patients with alternative treatment regimen. The difference was statistically significant (蠂 2 11.413 P 0.05). Conclusion Age and CD 4T cell count are the influencing factors of disharmonious reaction in patients with HARRT. The treatment with LPV/r regimen after disharmonious reaction can improve the immune function of patients and reduce the incidence of dissonant reactions.
【作者单位】： 广西柳州市人民医院感染病科;
【基金】：广西壮族自治区卫生厅自筹经费科研课题(Z2012561) 柳州市应用技术研究与开发计划项目(2011J0302021) 广西自然科学基金资助项目(2013GXNSFAA019213)
【分类号】：R512.91
[Abstract]:Objective to investigate the influencing factors of discordant reaction between (HARRT) HIV infected patients and AIDS patients with highly effective antiretroviral therapy and to observe the efficacy of Lopinowilitonavir (LPV/r). Methods from July 2006 to March 2013, 510 cases of HIV infected persons and AIDS patients who were treated with free antiviral therapy in Liuzhou people's Hospital and followed up were selected as the subjects. 174 patients with HARRT 12 months later had disharmonious reaction. Seventy of them agreed to replace it with a second-line therapy with LPV/r. The general data of the patients were collected, and the HIV RNA,CD 4T cell count, CD8T cell count, lymphocyte count, white blood cell count, hemoglobin and platelet count were recorded at the time of treatment and at 12 months after treatment. The increase of CD 4 T cell count in the second year was recorded between the patients who changed the treatment regimen and those who did not. Results Multivariate Logistic regression analysis showed that age (OR=1.037,95%CI (1.012 卤1.062) / P 0.004), CD 4T cell count (OR=0.988,95%CI (0.9820.995) / P0.001), CD 4T cell count (OR=0.991,95%CI (0.9850.997) / P0. 001) and CD 4T cell count (OR=0.993,95%CI (0.9880.998) / P 0.009) at 6 months after treatment. The lymphocyte count (OR=0.433,95%CI (0.230 卤0.816) entered the regression equation 6 months after treatment, which was the influencing factor of disharmonious reaction between HIV infected patients and AIDS patients. The number of CD 4T cells increased by 70.5 (119.5) / 渭 l in patients with no replacement treatment regimen and 147( 155.2) / 渭 l by CD _ 4T cells in patients with replacement treatment regimen. The difference was statistically significant (P 0.05). The rate of disharmonious reaction was 53.8% (56 / 104) in patients without replacement treatment regimen and 22.8% (16 / 70) in patients with alternative treatment regimen. The difference was statistically significant (蠂 2 11.413 P 0.05). Conclusion Age and CD 4T cell count are the influencing factors of disharmonious reaction in patients with HARRT. The treatment with LPV/r regimen after disharmonious reaction can improve the immune function of patients and reduce the incidence of dissonant reactions.
【作者单位】： 广西柳州市人民医院感染病科;
【基金】：广西壮族自治区卫生厅自筹经费科研课题(Z2012561) 柳州市应用技术研究与开发计划项目(2011J0302021) 广西自然科学基金资助项目(2013GXNSFAA019213)
【分类号】：R512.91
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