获得性免疫缺陷综合症抗病毒治疗失败情况及相关因素分析

发布时间：2018-08-09 14:09

【摘要】：目的了解获得性免疫缺陷综合症(AIDS)患者抗病毒治疗失败情况,分析影响抗病毒治疗失败的相关因素。方法对河南省中部地区接受抗病毒治疗方案6个月的AIDS患者进行横断面调查访谈和血样采集,全自动实时荧光定量病毒载量检测系统检测病毒载量,扩增/测序方法分析基因型耐药性,流式细胞术检测CD4~+T淋巴细胞;多因素Logistic回归分析法分析影响抗病毒治疗出现病毒学失败、基因型耐药和免疫学失败的相关因素。结果 740例抗病毒治疗患者中,出现病毒学失败(病毒载量1 000拷贝/m L)304例(41.1%)、基因型耐药243例(34.4%)、免疫学失败(CD4~+T淋巴细胞200个/μL)177例(23.9%),依从性差、治疗时间36个月、含去羟肌苷(dd I)的治疗方案是影响抗病毒治疗发生病毒学失败、基因型耐药的相关因素,男性、依从性差、含dd I的治疗方案是影响抗病毒治疗发生免疫学失败的相关因素。结论 AIDS患者抗病毒治疗失败的主要原因是出现病毒学失败、基因型耐药和免疫学失败,依从性差、含dd I的治疗方案是其相关因素。
[Abstract]:Objective to understand the failure of antiviral treatment in patients with acquired immunodeficiency syndrome (AIDS) and to analyze the related factors affecting the failure of antiviral therapy. Methods a cross-sectional interview and a collection of blood samples for AIDS patients in the central region of Henan province were interviewed for 6 months of antiviral therapy, and the full automatic real-time fluorescence quantitative viral load detection system was carried out. Detection of viral load, amplification / sequencing method analysis of genotype resistance, flow cytometry to detect CD4~+T lymphocytes, multiple factor Logistic regression analysis to analyze the related factors affecting virological failure, genotype resistance and immunological failure in antiviral therapy. Results 740 cases of antiviral treatment patients had virological failure (disease). 1000 copies of /m L), 243 cases of genotype resistance (34.4%), 177 cases of immunological failure (CD4~+T lymphocyte 200 / L) 177 cases (23.9%), poor compliance, and treatment time for 36 months, and the treatment scheme containing DD I was the related factors of virological failure in antiviral therapy, related factors of genotype resistance, male, poor compliance, DD The treatment scheme of I is a related factor affecting the immunological failure of antiviral therapy. Conclusion the main cause of the failure of antiviral therapy in AIDS patients is the emergence of virological failure, genotypic and immunological failure, and poor compliance, and the DD I therapy is the related factor.
【作者单位】：河南省疾病预防控制中心;中国疾病预防控制中心;
【基金】：河南省重点科技攻关计划项目(102102310003,112102310005)
【分类号】：R512.91

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