Clinical outcomes and immune reconstitution in 103 advanced AIDS patients undergoing 12-month highly active antiretroviral therapy

作     者：DAI Yi QIU Zhi-feng LI Tai-sheng HAN Yang ZUO Ling-yan XIE Jing MA Xiao-jun LIU Zheng-yin WANG Ai-xia 

作者机构：Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2006年第119卷第20期

页      面：1677-1682页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：This study was supported by the grants from the National Key Technologies R&D Program for the 10th Five-Year Plan (No. 2004BA719A10)  the HIV/AIDS Prevention and Treatment Project of Ministry of Health (No. WA2003-05)  and the Critical Clinical Project of Ministry of Health 

主　　题：acquired immunodeficiency syndrome antiretroviral therapy, highly active CD4 lymphocyte count immune reconstitution adverse effects 

摘      要：Background Highly active antiretroviral therapy （HAART） produces profound suppression of HIV replication, substantial increase in CD4^＋ T cells, and partial reconstitution of the immune system. However, the numbers of subjects were small in previous Chinese studies. This study evaluated the efficacy and side effects of HAART in Chinese advanced AIDS patients. Methods One hundred and three antiretroviral drug naive AIDS patients were enrolled in this study and were divided into two groups by their baseline CD4^＋ count： 〈 100 cells/μl or ≥ 100 cells/μl. Clinical, virological and immunological outcomes were monitored at baseline and at 1, 3, 6, 9 and 12 months during the course of treatment with HAART. Results One patient died and another was lost from the follow-up. For the remaining 101 HIV/AIDS patients at the 12th month during the HAART, the plasma viral load （VL） was reduced to （3.2±0.7） lg copies/ml, the CD4^＋ count increased to （168 ±51） cells/μl [among which the naive phenotype （CD45RA^＋CD62L^＋） increased to （49 ±27） cells/μl and the memory phenotype （CD45RA^-） increased to （119 ±55） cells/μl], and the percentage of CD4^＋CD28^＋ cells increased. At the same time, there was a significant reduction of CD8^＋ T cell activation. In the 69 patients with the baseline CD4^＋ count 〈100 cells/μl, 37 had a VL 〈50 copies/ml; while in the 34 patients with the baseline CD4^＋ count ≥ 100 cells/μl, 25 had a VL 〈50 copies/ml, the difference between the two groups was statistically significant. The CD4^＋ T cell count showed a two-phase increase during HAART and a significant positive correlation was shown between the change of CD4^＋ count and plasma VL. Over 12 months of HAART, 10 patients had gastrointestinal side effects, 13 peripheral neuritis, 7 hepatic lesions, 8 hematological side effects, 8 skin rashes, 10 lipodystrophy and 1 renal calculus. Conclusions Immune reconstitution as well as the significantly improved clinical outcomes is observed in Chinese advanced AIDS pat