三种不同初始标准抗病毒方案治疗女性艾滋病的疗效分析

发布时间：2018-05-28 17:26

本文选题：艾滋病病毒感染女性 + 初治　；参考：《中国艾滋病性病》2017年09期

【摘要】：目的比较克立芝(LPV/r)或依非韦伦(EFV)或奈韦拉平(NVP)联合两个核苷类反转录酶抑制剂作为初始标准抗病毒治疗方案,治疗女性艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS)的效果。方法收集2006-2015年在广西壮族自治区内使用上述抗病毒方案治疗的15~44岁女性病人的随访资料。采用倾向得分匹配方法对三组间基线年龄、CD4~+T淋巴细胞(简称CD4细胞)计数、感染途径等进行匹配,比较三种抗病毒方案在治疗开始和治疗后随访48周、96周、144周和192周时血浆HIV核糖核酸(RNA)载量、CD4细胞数。结果入组1 035例,每组均为345例。病毒学疗效:EFV组、NVP组、LPV/r组的病毒抑制率在治疗48周时分别为86.0%、87.6%、89.2%;在96周时分别为91.5%,84.1%,94.5%;192周时,分别为93.3%,93.2%,92.7%;各组均可达到较高的病毒抑制率。除96周,LPV/r组和EFV组显著高于NVP组(P=0.008),其余时间点组间差异无统计学意义(P=0.601,P=0.286)。免疫学疗效:治疗随访192周,三组的CD4细胞数较基线都有明显增加,LPV/r组的CD4~+T淋巴细胞增长值明显高于EFV、NVP组,LPV/r组平均增长(342.71±176.94)个/μL,EFV组平均增长了(310.24±194.63)个/μL,NVP组平均增长(258.09±177.22)个/μL,三组差异具有统计学意义(P0.001),对于基线CD4细胞数200个/μL者,192周时LPV/r组的CD4细胞数增长也优于EFV或NVP组。结论三种抗病毒方案对女性HIV/AIDS病人的血浆HIV病毒抑制率无差异,含LPV/r的治疗方案在提升CD4细胞数的方面占据优势。
[Abstract]:Objective to compare the efficacy of two nucleoside reverse transcriptase inhibitors (NPIs) in the treatment of HIV / AIDS patients with HIV / AIDS (HIV / AIDS / AIDS) patients (HIV / AIDSs) in combination with two nucleoside reverse transcriptase inhibitors (Nvir) or EFV (EFV) or nevirapine (NVP). Methods the follow-up data of 1544 year old female patients who were treated with the above antiviral regimen in Guangxi Zhuang Autonomous region from 2006 to 2015 were collected. To match the baseline age, CD4T lymphocyte (CD4 cell) count and infection pathway between the three groups, the tendency score matching method was used. The number of CD4 cells in plasma HIV ribonucleic acid (RNAs) was compared at the beginning of treatment and the follow-up of 48 weeks, 96 weeks and 192 weeks after treatment with three antiviral regimens. Results there were 1 035 cases in each group, 345 cases in each group. The viral inhibition rate in the EFV group was 86.0 at 48 weeks after treatment, and 87.6 in the EFV group, and 91.5 in 94.51 at the 96th week, 93.292.7at the 192nd week. The virus inhibition rate in each group was 93.292.70.The inhibition rate of the virus was higher in each group than that in the control group. There was no significant difference between the two groups at 96 weeks (P = 0.601a, P = 0.286) except that in the NVP group and EFV group were significantly higher than that in the NVP group (P = 0.008) at 96 weeks. Immunological efficacy: treatment followed up for 192 weeks, The number of CD4 cells in the three groups was significantly higher than that in the baseline group. The increase of CD4 ~ T lymphocytes in the LPV-R group was significantly higher than that in the LPV-NVP / 渭 LPV-rr group, which was significantly higher than that in the CD4 / 渭 LPV-rr group. The average increase of CD4T cells in the three groups was 310.24 卤194.63 / 渭 LNVP / 渭 LNVP group (258.09 卤177.22) / 渭 L / 渭 L respectively, and the difference among the three groups was statistically significant. The number of CD4 cells in LPV/r group was also higher than that in EFV or NVP group at 192 weeks after the baseline CD4 cell count was 200 / 渭 L. Conclusion there is no difference in the inhibition rate of plasma HIV virus among the three antiviral regimens in female patients with HIV/AIDS. The treatment regimen containing LPV/r has the advantage in increasing the number of CD4 cells.
【作者单位】：广西艾滋病诊疗质控中心广西壮族自治区龙潭医院;
【基金】：国家十二五重大科技专项(2012ZX10004910-006-002,2012ZX10001003-001)~~
【分类号】：R512.91

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