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[目的]了解大冶市艾滋病人抗病毒治疗失败及耐药情况,为开展二线药物治疗工作提供依据。[方法]对大冶市接受国家免费抗病毒治疗病人的国家数据库资料和病人档案资料进行病毒学、免疫学及临床分析,对诊断病毒学失败的患者再分析其耐药情况。[结果]81位长期接受抗病毒治疗的病人中有12人病毒载量处于较高水平,病毒学失败率为14.81%,最近一次病毒载量平均值为(4.32±0.35)log拷贝/ml;12例病毒学失败患者中有6人出现了免疫学失败,占50.00%,其免疫学失败时间平均为28.57人月;6例免疫学失败患者中,临床失败者3例,占50.00%。接受耐药检测的11例患者,每例至少对一种药物产生高度耐药,耐药发生率100%;对NVP、EFV、AZT、D4T、DDI等的高度耐药率分别为100%、91.67%、81.82%、63.64%、9.1%;存在交叉耐药。[结论]抗病毒治疗失败患者高度耐药情况严重,应及早开展二线药物治疗。
[Objective] To understand the failure and drug resistance of antiviral treatment for AIDS patients in Daye City and provide basis for the second-line drug treatment. [Method] Virology, immunology and clinical analysis were carried out in national database and patient files of patients receiving national free anti-virus treatment in Daye City to analyze the drug resistance of patients who failed in the diagnosis of virology. [Results] Twelve of 81 patients with long-term antiviral therapy had high viral load, the virological failure rate was 14.81%, and the average of the latest viral load was (4.32 ± 0.35) log copies / ml; Immunological failure occurred in 6 out of 12 patients with virological failure, accounting for 50.00%. The mean time of immunological failure was 28.57 months. Of 6 immunocompromised patients, 3 failed, accounting for 50.00%. Eleven patients receiving drug resistance test showed that each patient was highly resistant to at least one drug and the drug resistance rate was 100%. The high rates of resistance to NVP, EFV, AZT, D4T and DDI were 100% and 91.67, respectively %, 81.82%, 63.64%, 9.1%; there is cross-resistance. [Conclusion] Patients with failure of anti-virus therapy are highly resistant and should be treated with second-line drugs as soon as possible.