HIV 治疗的启动

早期治疗可延长预期寿命

 

背景

越来越多的研究认为，只要患者在病程中尽早开始治疗并坚持接受抗病毒药物治疗，HIV（人类免疫缺陷病毒）可以视作为一种预后良好的慢性疾病。目前，此类患者的预期寿命可与患糖尿病等其他慢性疾病的普通人群类似。 本文陈述了一项研究的结果，该研究针对预期寿命，将 HIV 感染患者与普通人群进行了比较。 该研究也探究了在病程早期开始抗逆转录病毒治疗对预期寿命的影响。吉林市人民医院皮肤科冯志宏

• 英国的合作艾滋病毒队列 (UK CHIC) 研究在 2001 年启动并纳入了 35,377 名 HIV 患者的数据。
• 纳入分析的 17,661 名患者存在 HIV-1、年龄不小于 20 岁、CD4 细胞计数 ≤ 350 细胞/mm³ （在英国这一指标为无症状患者启动治疗的阈值）。 受试者均于 1996 年 1 月 1 日至 2008 年 12 月 31 日间开始抗逆转录病毒治疗。
• 主要预后为确切年龄在 20 岁时的预期寿命。
• 在 1996 年至 1999 年间开始治疗的患者，其预期寿命（20 岁时）为 30.0 年。 在 2006 年至 2008 年间启动治疗的患者，其预期寿命为 45.8 年。
• 男性和女性 HIV 患者（20 岁时）的预期寿命（分别为 39.5 年和 50.2 年）低于普通人群（分别为 57.8 年和 61.6 年）。
• CD4 细胞计数 <100、100?199 及 200?350 细胞/mm³ 时启动治疗的患者的预期寿命（20 岁时）分别为 37.9 年、41.0 年及 53.4 年。

结论

HIV 患者间的预期寿命在最近十年已得到改善，但仍低于普通人群。在病程早期启动抗逆转录病毒治疗对预期寿命具有积极的影响。

May M, Gompels M, Delpech V, et al. Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) study. BMJ. 2011;343:d6016.doi:10.1136/bmj.d6016.

访问 TheLancet.cn 主页

 

Purchase full-text article at PubMed

© 2011 Excerpta Medica BV. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the copyright owner. No responsibility is assumed by the Publisher for any injury and/or damage to persons or property as a matter of products liability, through negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Because of rapid advances in the medical sciences, the Publisher recommends that independent verification of diagnoses and drug dosages should be made. Opinions expressed in this publications are those of the original authors and do not necessarily reflect those of the Published, the sponsor, or the editors. Excerpta Medica assumes no liability for any material published herein. Just Published has been made possible by univadis, a service offered by MSD.

The translation has been undertaken by SDL PLC at its sole responsibility. No responsibility is assumed by Excerpta Medica in relation to the translation or for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made.