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| 快速启动抗反转录病毒治疗对HIV/AIDS患者病毒学抑制的影响 |
| Effect of rapid initiation of antiretroviral therapy on virological suppression in patients with HIV/AIDS |
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| DOI：10.3969/j.issn.1007-8134.2023.04.09 |
| 中文关键词: 艾滋病病毒 快速启动 抗反转录病毒治疗 病毒抑制 |
| 英文关键词: HIV rapid start antiretroviral therapy virus inhibition |
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| 中文摘要: |
| 目的?了解贵阳市2018—2020年HIV/AIDS患者快速启动抗病毒治疗对病毒学抑制的影响。方法?采用回顾性研究方法，选取2018年1月1日—2020年12月31日贵阳市新启动抗反转录病毒治疗（antiretroviral therapy, ART）的患者，根据确证至启动ART时间不同将研究对象分为快速启动组（≤7 d）和非快速启动组（＞7 d）。结果?共纳入研究对象547例，其中非快速启动组269例（49.18％），快速启动组278例（50.82％），快速启动组48周病毒学抑制率高于非快速启动组（96.4％ vs. 87.73％，χ2=13.023，P=0.001）。快速启动组达到病毒学抑制的中位时间比非快速启动组快9 d（170 d vs. 179 d，W=1 000，P=0.001）。多因素分析结果显示与ART方案为2NRTIs+INSTIs的患者相比，方案为2NRTIs+NNRTIs的患者在48周病毒学抑制失败率更高，基线高病毒载量、非快速启动是病毒学抑制失败的危险因素。结论?快速启动ART能提高HIV/AIDS患者48周病毒学抑制率、缩短病毒学抑制的时间。HIV确证后应快速启动ART。 |
| 英文摘要: |
| Objective To investigatethe effect of rapid initiation of antiviral therapy on virological inhibition of HIV/AIDS patients in Guiyang from 2018 to 2020. Methods?A retrospective study was conducted to select the newly initiated active anti- retroviral therapy (ART) patients in Guiyang from January 1, 2018 to December 31, 2020. The subjects were divided into rapid start group (confirmed to start ART for≤7 d) and non-rapid start group (confirmed to start ART for＞7 d). Results?A total of 547 subjects were enrolled, including 269 (49.18%) in the non-rapid start group and 278 (50.82%) in the rapid start group. The virological inhibition rate of the rapid start group at 48 weeks was higher than that of the non-rapid start group (96.4% vs. 87.73%, χ2 =13.023, P= 0.001). The median time for rapid start group to achieve virological inhibition was 9 d faster than that of non-rapid start group (170 d vs. 179 d, W= 1 000, P=0.001). Multivariate analysis showed that compared with patients with ART regimen of 2NRTIs+INSTIs, regimen of 2NRTIs+NNRTIs had a higher failure rate of virological inhibition at 48 weeks. High baseline viral load and non-rapid start were the risk factors of virological inhibition failure. Conclusions?Rapid start can improve the virological inhibition rate at 48 weeks and shorten the time of virological inhibition. After HIV confirmed, ART should be started quickly. |
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