无国界医生及广西壮族自治区疾病预防控制中心艾滋病项目三年抗病毒治疗结果分析
An analysis of antiretroviral therapy outcomes in the Medecins Sans Frontieres/Guangxi Center for Disense Control and Provention HIV/AIDS project
目的 分析无国界医生及广西壮族自治区疾病预防控制中心AIDS免费综合治疗关怀项目(以下简称项目)3年治疗结果及面临的挑战.方法 回顾性分析2003年12月-2006年12月随访的432例接受高效抗逆转录病毒治疗(HAART)患者的治疗结果.结果 成年患者病死率为6.5%,失访率为2.8%.接受治疗9~15个月和21~27个月的患者,CD+4T细胞计数增长分别为147个/μl和246个/μl.2006年3月-12月进行的治疗依从性评估显示,95.9%的患者依从性≥95%.在接受HAART的30例儿童中,4例(13.3%)死亡,抗病毒治疗后9~15个月CD+4T细胞计数平均增长值为673个/μl;治疗后21~27个月CD+4 T细胞计数平均增长值为658个/μl.148例静脉注射吸毒者(IDU)或既往IDU接受了HARRT,其病死率和失访率与非IDU人群的差异无统计学意义(Logrank test,P=0.91).结论 联合抗病毒治疗取得了很好的中期治疗结果.完全免费的关怀和治疗、对患者强有力的咨询和支持是项目成功的关键因素.
更多Objective To evaluate the 3-year outcomes of the Medecins Sans Frontieres/Guangxi Center for Disease Control and Provention comprehensive and free of charge HIV/AIDS treatment and care project.Methods We present a detailed retrospective analysis of treatment outcomes of 432 cases who received highly active antiretroviral therapy (HAART)from December 2003 to December 2006.Results Among the adult patients who received HAART,the mortality rate was 6.5%and only 12(2.8%)patients were lost to follow up.The mean CD+4 T cell count increase was 147 cells/μl and 246 cells/μl for patients receiving HAART for 9-15 and 21-27 months respectively.An adherence assessment conducted during March to December 2006 indicated that 95.9%of the study cases reached an adherence of 95%or more of the prescribed medications.Among the 30 children patients who received HAART,4(13.3%)cases died and the mean CD4+T cell increase after 9-15 and 21-27 months of HAART was 673cells/μl and 658 cells/μlrespectively.148 of the adult patients starting HAART were current or ex-intravenous drug users(IDU)and showed global death rate and lost to follow-up rate comparable to those of non-IDU patients(Log rank test,P=0.91).Conclusions Good mid-term therapeutic outcomes with combination antiretroviral therapy have been achieved in this project.Total free of charge care and treatment and intensive patient support/counseling are crucial to program success.
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