CAJ | 학술논문

目的：探讨抗结核治疗联合高效抗反转录病毒治疗（ HAART）对AIDS合并结核病（ AIDS／TB）患者HIV耐药性的影响。方法101例AIDS患者（对照组）接受HAART，实验组126例AIDS／TB患者（实验组）抗结核治疗2～8周后开始HAART。监测两组患者的HIV病毒载量及CD4＋T细胞计数，对HIV病毒载量大于1000拷贝／ml的患者进行基因型耐药检测，比较两组耐药情况及HAART疗效。结果治疗24周时，实验组有7例患者病毒载量大于1000拷贝／ml，其中1例检测出耐药突变基因，为蛋白酶（ PR）基因检测次要耐药位点；对照组有1例病毒载量大于1000拷贝／ml，但未检出HIV耐药突变基因。两组患者基因型耐药发生率差异无统计学意义（P＞0．05）。两组患者治疗后CD4＋T细胞计数均较治疗前上升，但两组组间治疗前后CD4＋T细胞计数比较，差异均无统计学意义（P＞0．05）。治疗48周时两组患者病毒载量均低于检测下限。结论 AIDS／TB双重感染者同时接受抗结核及HAART，未导致HIV耐药性的产生。
목적：탐토항결핵치료연합고효항반전록병독치료（ HAART）대AIDS합병결핵병（ AIDS／TB）환자HIV내약성적영향。방법101례AIDS환자（대조조）접수HAART，실험조126례AIDS／TB환자（실험조）항결핵치료2～8주후개시HAART。감측량조환자적HIV병독재량급CD4＋T세포계수，대HIV병독재량대우1000고패／ml적환자진행기인형내약검측，비교량조내약정황급HAART료효。결과치료24주시，실험조유7례환자병독재량대우1000고패／ml，기중1례검측출내약돌변기인，위단백매（ PR）기인검측차요내약위점；대조조유1례병독재량대우1000고패／ml，단미검출HIV내약돌변기인。량조환자기인형내약발생솔차이무통계학의의（P＞0．05）。량조환자치료후CD4＋T세포계수균교치료전상승，단량조조간치료전후CD4＋T세포계수비교，차이균무통계학의의（P＞0．05）。치료48주시량조환자병독재량균저우검측하한。결론 AIDS／TB쌍중감염자동시접수항결핵급HAART，미도치HIV내약성적산생。
Objective To investigate the HIV drug resistance of AIDS patients complicated with tuberculosis ( AIDS/TB) who have accepted anti-tuberculosis treatment and highly active anti-retroviral therapy(HAART).Methods One hundred and one AIDS patients in the control group accepted HAART,and 126 AIDS/TB patients in the experimental group accepted HAART after 2 to 8 weeks of anti-tuberculosis treatment.The HIV viral load and CD4+T lymphocyte count of the patients were monitored in two groups .The drug resistant genotype test was performed among patients with HIV viral load more than 1 000 copies/ml.The result of HIV drug resistant genotype test and the effect of HAART were compared between two groups.Results After a 24-week treatment,the secondary resistance loci of protease (PR) gene was detected in 1 of 7 cases whose HIV viral load more than 1 000 copies/ml in the experimental group.And there was only 1 case whose HIV viral load more than 1 000 copies/ml,but no HIV resistant genotype was detected in the control group .There was no significant difference in the incidence of drug resistant genotype between two groups(P>0.05).The CD4+T lymphocyte count increased after treatment in contrast with that before treatment in two groups,but the CD4+T lymphocyte count before or after treatment showed no significant difference between two groups(P>0.05).The HIV viral load of the patients achieved the undetectable level after a 48-week treatment in two groups.Conclusion HIV drug resistance might not be observed in the AIDS patients complicated with TB who have accepted anti-tuberculosis treatment and HAART at the same time .