A 7year multicenter prospective study on highly active antiretroviral therapy in HIV1 infected patients in

Abstract:

To prospectively observe the efficacy, tolerance , immune reconstruction and toxicity of longterm highly active antiretroviral therapy (HAART) in HIVinfected patients in China.MethodsFour hundred and thirtyseven HIVinfected patients initiated HAART and originally received two nucleoside reverse transcriptase inhibitors（NRTI） and one nonnucleoside reverse transcriptase inhibitors（NNRTI）, and were traced  HIV RNA levels, T lymphocyte subsets, blood routine tests, main laboratory parameter changes and treated for active opportunistic infections. Patients with severe side effects or virological failure changed to the second line regimens.Results437 patients from 8 hospitals received a  mean of  4.69 years (3.15~7.34) followup. Total mortality was 6.86 %, and the majority of patients  died within the first 6 months  of the treatment. The proportion of subjects who had HIV1 RNA＜500 copies/mL were 90.80%, 63.46%, 69.41%, 70.00%, and 72.22% at 1,4,5,6 and 7 year (±1 month) respectively. CD4+ T cell count were 115, 246, 301, 334, 363, 356,386 and 373 cells/μL at 0, 1, 2, 3, 4, 5, 6 and 7 year （±1 month） of followup, respectively. 67.73% of HIVinfected patients showed various drugrelated side effects, the majoriy were digestive system symptoms , neurological system symptoms, liver dysfunction, marrow toxicity ,skin rash, and hyperlipemia, et al. 19.22%  of patients changed their primary regimens into other firstline drugs for drugrelated side effects, 11.67%  of patients switch to secondline regimen for viral resistance. ConclusionThis paper firstly reported the 3 to 7year results from the multicenter prospective followup of HIVinfected patients in China taking potent antiretroviral therapy. The study demonstrated antiretroviral therapy with two NRTI and one NNRTI regimen may persistently suppress HIV and increase CD4 cell in a majority of subjects. The majority of subjects take firstline regimen effectively, minor switch to secondline regimen for drugrelated side effects or viral resistance.