發(fā)布時間：2018-02-25 17:46

  本文關(guān)鍵詞： 艾滋病病毒 老年感染者 抗病毒治療　出處：《中國艾滋病性病》2017年09期 　論文類型：期刊論文

【摘要】：目的分析廣西≥50歲艾滋病病毒(HIV)感染病人采用不同初始治療方案的療效,為老年HIV感染病人的抗病毒治療(ART)提供臨床經(jīng)驗。方法將1 893例老年HIV感染病人分為3組,每組631例,分別用含洛匹那韋/利多那韋(LPV/r)、依非韋倫(EFV)、奈韋拉平(NVP)的標(biāo)準(zhǔn)三聯(lián)方案進行初始治療,分析比較3組的病毒學(xué)、免疫學(xué)效果。結(jié)果三組病人的基線特征中,性別差異有統(tǒng)計學(xué)意義(P=0.015),其他指標(biāo)均無差異。12個月時,LPV/r組、EFV組、NVP組的病毒抑制率分別為82.17%、87.24%、80.04%,EFV組的病毒抑制率明顯高于NVP和LPV/r組(P=0.006),是NVP組的1.71倍[95%可信區(qū)間(CI):1.22~2.38],LPV/r組的1.48倍(95%CI:1.06~2.08)。進一步分析發(fā)現(xiàn),12個月時,LPV/r組與EFV組在病毒載量(VL)400拷貝/mL及VL1 000拷貝/mL水平的抑制率無差異(P0.05),并且均高于NVP組(P0.05)。隨后LPV/r組、EFV組、NVP組的病毒抑制率在24個月時,分別為87.26%、86.06%、83.46%,在36個月時為93.30%、91.62%、90.03%,在48個月時為88.00%、90.59%、93.60%,3組間差異無統(tǒng)計學(xué)意義(P0.05)。免疫學(xué)方面,治療后6~42個月,3組間的CD4~+T淋巴細胞計數(shù)差異有統(tǒng)計學(xué)意義(P0.05),LPV/r組顯著高于NVP組和EFV組,而第48個月,3組間差異雖然無統(tǒng)計學(xué)意義(P=0.084),但LPV/r組的均值高于EFV和NVP組。結(jié)論含LPV/r、EFV、NVP的不同初治方案治療老年HIV感染病人均獲良好的療效。含LPV/r的初治方案雖然在1年時的病毒抑制率低于EFV方案,但4年的長期病毒抑制率并無差別,在免疫學(xué)效果上的優(yōu)勢突出。
[Abstract]:Objective to analyze the efficacy of different initial treatment regimen in patients with HIV infection over 50 years old in Guangxi, and to provide clinical experience for antiviral therapy in elderly patients with HIV infection. Methods 1 893 elderly patients with HIV infection were divided into 3 groups. A total of 631 patients in each group were treated with a standard triple regimen containing lopinavir / ridonavir, EFVN, nevirapine NVP, respectively. The virological and immunological effects of the three groups were analyzed and compared. Results in the baseline features of the three groups, At 12 months, the virus inhibition rate of NVP / R group was 82.17 and 87.24 ~ 80.04% respectively, which was significantly higher than that of NVP and LPV/r group P0.006, and 1.71 times that of NVP group [95% CI: 1.22 / 2.38] LPV-R group. Further analysis showed that there was no difference in the inhibition rates of virus load between LPV-r group and EFV group at the levels of 400 copies / mL and #number0# copies / mL of VL1 at 12 months, and both of them were higher than those of NVP group (P0.05). Subsequently, the inhibition rate of virus in LPV/r group was at 24 months. There was no significant difference in CD4T lymphocyte counts between the three groups at 36 months after treatment and 88.00 at 48 months (P 0.05). In immunology, the number of CD4T lymphocytes in the three groups was significantly higher than that in the NVP group and the EFV group at 6 ~ 42 months after treatment, and there was a significant difference in the number of CD4T lymphocytes between the three groups after treatment (P < 0.05), and there was no significant difference in the number of CD4T lymphocytes between the three groups (P < 0.01 or P < 0.05), and the number of CD4T lymphocytes in the three groups was significantly higher than that in the NVP group and the EFV group (P < 0.05), which was significantly higher than that in the NVP group and the EFV group (P < 0.05). Although there was no significant difference among the three groups in the 48th month, the mean value of LPV/r group was higher than that of EFV and NVP group. Conclusion the different initial treatment regimens with LPV-r-EFVV LPV/r have good curative effect on the elderly patients with HIV infection. Although the initial treatment regimen with LPV/r is better than that of EFV and NVP groups, the initial treatment regimen with LPV/r can be used in the treatment of elderly patients with HIV infection. The virus inhibition rate at 1 year was lower than that of EFV regimen. But 4 years long-term virus inhibition rate has no difference, in immunological effect superiority is outstanding.
【作者單位】： 廣西壯族自治區(qū)龍?zhí)夺t(yī)院;
【基金】：國家十二五科技重大專項:(2012ZX10004910-006-002)~~
【分類號】：R512.91

【相似文獻】

相關(guān)期刊論文 前1條

1 繆曉輝;;乙肝初始治療 正確選藥很關(guān)鍵[J];醫(yī)藥與保健;2012年02期

相關(guān)會議論文 前1條

1 李晨;段學(xué)章;胡瑾華;王慧芬;;基線MELD值、MELD-Na值對初始治療HBV相關(guān)ACLF患者近期預(yù)后的評估價值[A];第四屆中國醫(yī)師協(xié)會感染科醫(yī)師大會暨傳染病診治高峰論壇、浙江省醫(yī)學(xué)會肝病、感染病學(xué)學(xué)術(shù)年會論文匯編[C];2011年

相關(guān)重要報紙文章 前1條

1 記者 郭靜 通訊員 楊炯;粵出臺乙肝初始治療方案[N];廣東科技報;2009年

，

本文編號：1534549