目的近年的研究证明,即使是晚期的1型人类免疫缺陷病毒(HIV-1)感染者经高效联合抗逆转录病毒治疗(Highly active antiretroviral therapy,HAART)后,其血浆病毒载量显著减少、cD4+T细胞计数明显增加,但HAART对改善cD4+T细胞功能尚不十分...
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目的近年的研究证明,即使是晚期的1型人类免疫缺陷病毒(HIV-1)感染者经高效联合抗逆转录病毒治疗(Highly active antiretroviral therapy,HAART)后,其血浆病毒载量显著减少、cD4+T细胞计数明显增加,但HAART对改善cD4+T细胞功能尚不十分清楚。为此,我们进行了此项开放性前瞻性研究。方法20例病人均接受由1种HIV蛋白酶抑制剂和2种逆转录酶抑制剂联合组成的高效抗病毒治疗(HAART),在治疗前和治疗后第1、3、6、9和12个月时,分别测定病人对巨细胞病毒和结核菌抗原的特异性cD4+T细胞免疫应答反应。结果经1年的HAART,20例病人的血浆HIV载量平均下降了1.5log拷贝/ml,cD4+T细胞计数平均上升63/μ1。开始HAART前,仅有4位患者对特异性抗原有反应,治疗1年后有10位患者重新恢复了对特异抗原的免疫反应(PcD4+T细胞计数明显增加。结论HAART治疗能够恢复艾滋病病人cD4+T细胞抗机会病原体的免疫功能,这种恢复与治疗前已破坏的免疫功能严重程度无关,而取决于治疗后cD4+T细胞增加的幅度、病毒复制被控制的程度和持续的时间。
AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions(RAS).METHODS Human immunodeficiency virus(HIV)/hepatitis c virus(HcV) coinfected patients starting a first...
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AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions(RAS).METHODS Human immunodeficiency virus(HIV)/hepatitis c virus(HcV) coinfected patients starting a first direct-acting antiviral(DAA) regimen before February 2016 and included in the French ANRS cO13 HEPAVIH cohort were eligible. Failure was defined as:(1) non-response [HcV-RNA remained detectable during treatment, at end of treatment(EOT)]; and(2) relapse(HcVRNA suppressed at EOT but detectable thereafter). Sequencing analysis was performed to describe prevalence of drug class-specific RAS. Factors associated with failure were determined using logistic regression *** Among 559 patients, 77% had suppressed plasma HIV-RNA copies/mL at DAA treatment initiation, 41% were cirrhotic, and 68% were HcV treatmentexperienced. Virological treatment failures occurred in 22 patients and were mainly relapses(17, 77%) then undefined failures(3, 14%) and non-responses(2, 9%). Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5 A or NS5 b RAS were detected in 10/14 patients with samples available for sequencing analysis. After adjustment for age, sex, ribavirin use, HcV genotype and treatment duration, low platelet count was the only factor significantly associated with a higher risk of failure(OR: 6.5; 95%cI: 1.8-22.6). cONcLUSION Only 3.9% HIV-HcV coinfected patients failed DAA regimens and RAS were found in 70% of those failing. Low platelet count was independently associated with virological failure.
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