Efficacy Analysis Of Antiviral Therapy For Aids Patients In A Hos Pital In Jiangxi Province After 1 Year

Objective:To analyze the immunological recovery effect and viral load suppression o f AIDS patients in Jiangxi Chest Hospital who received free AIDS antiviral th erapy for one year(12±1 month),and to study the influencing factors of im mune reconstitution and viral load suppression.To study the correlation betwee n CD4+T lymphocytes(CD4 cells for short)and viral load after 1 year of ant iviral therapy(12±1 month).The degree of drug resistance to different antivir al drugs and the distribution of mutation sites in patients with failed virus sup pression were analyzed.Methods:History cards of patients receiving antiviral therapy in Chest Hospital of J iangxi Province,including basic information and follow-up data,were downloa ded from the comprehensive AIDS Prevention and treatment information syste m of Chinese Center for Disease Control and Prevention,and antiviral therapy data of adults(aged≥18 years at the beginning of treatment)who were first treated between January 2014 and December 2017 were screened.The differe nce of CD4 cells before treatment and 1 year(12±1 month)after treatment w as used to analyze the immune reestablishment status of patients.The influenci ng factors of CD4 cells and viral load inhibition were analyzed using baseline data of patients,respectively,to evaluate the efficacy of antiviral therapy.The correlation between viral load and CD4 cells was analyzed by logarithmic co nversion.The incidence of drug resistance,individual degree of drug resistance and main mutation sites were analyzed according to patient resistance monitor ing report.Results:The median CD4 cell count of 379 HIV/AIDS patients was 254(172,372)cells/mm~3after antiviral therapy for 1 year,and 135(56,264)cells/mm~3befor e treatment,which was higher after treatment than before treatment(Z=-11.839,P<0.05).The median increment of CD4 cell count was 102(18,200)cells/m m~3.CD4 cells at different baselines were negatively correlated with the increas e of CD4 cells after 1 year of antiviral therapy(r=-0.408,P<0.01).There was statistical significance in the number of CD4 cell growth≥100 cells/mm~3in patients with different CLINICAL stages and baseline CD4 cell count level af ter 1 year of antiviral treatment(P<0.05).After 1 year of antiviral therapy,62 patients(16.4%)had viral load≥400 copies/m L.There were 317 cases(83.6%)with viral load<400 copies/m L,among which 302 cases(79.7%)were undetected.After multivariate Logisti c regression analysis,Gender(OR=0.230,95%CI=0.069-0.768,P<0.05)and th e presence of tuberculosis in the last year(OR=3.643,95%CI=1.085-12.227,P<0.05)had a statistically significant relationship with viral load suppression fa ilure.Correlation analysis results showed negative correlation between CD4 cell number and viral load(r=-0.329,P<0.01).The correlation between CD4 cell number and viral load was different in different CD4 cell ranges,and only the correlation between 0～199 group and viral load was statistically significant(r=-0.442,P<0.01).There was no significant correlation between viral load a nd 200～349 groups and 350 and above groups(P>0.05).After 1 year of antiviral treatment,the incidence of drug resistance in pati ents was 4.22%,and the drug resistance of NRTIs and NNRTIs was also serio us,and the drug resistance constituent ratio was 87.5%.Conclusion:1.The immunological effect of HIV/AIDS patients recovered significantly after 1 year of antiviral therapy;After 1 year of antiviral therapy,the increase of low level of BASELINE CD4 cells was higher than that of high level gro up.Baseline WHO clinical stage and baseline CD4 cells are influencing factor s of immune reconstitution.2.After 1 year of antiviral therapy,the effect of viral load suppression w as significant;Gender and the presence of TUBERCULOSIS in the past year were influential factors for failure to suppress viral load.3.There was a significant negative correlation between CD4 cell value an d virus load value.4.After 1 year of antiviral therapy,the drug resistance rate of patients tre ated with antiviral therapy was 4.22%,which belongs to the low epidemic stat e of drug resistance.The mutation of locus 184V was the highest in NRTIs dr ugs,and the mutation of locus 184V was mainly related to 3TC.