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首页> 外文期刊>The New England journal of medicine >Antiretroviral therapy in a thousand patients with AIDS in Haiti.
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Antiretroviral therapy in a thousand patients with AIDS in Haiti.

机译：海地一千名艾滋病患者的抗逆转录病毒疗法。

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BACKGROUND: The one-year survival rate of adults and children with the acquired immunodeficiency syndrome (AIDS), without antiretroviral therapy, has been about 30 percent in Haiti. Antiretroviral therapy has recently become available in Haiti and in other developing countries. Data on the efficacy of antiretroviral therapy in developing countries are limited. High rates of coinfection with tropical diseases and tuberculosis, along with malnutrition and limited laboratory monitoring of therapy, may decrease the efficacy of antiretroviral therapy in these countries. METHODS: We studied the efficacy of antiretroviral therapy in the first 1004 consecutive patients with AIDS and without previous antiretroviral therapy who were treated beginning in March 2003 in Port-au-Prince, Haiti. RESULTS: During a 14-month period, three-drug antiretroviral therapy was initiated in 1004 patients, including 94 children under 13 years of age. At enrollment, the median CD4 T-cell count in adults and adolescents was 131 per cubic millimeter (interquartile range, 55 to 211 per cubic millimeter); in children, a median of 13 percent of T cells were CD4-positive (interquartile range, 8 to 20 percent). According to a Kaplan-Meier survival analysis, 87 percent of adults and adolescents and 98 percent of children were alive one year after beginning treatment. In a subgroup of 100 adult and adolescent patients who were followed for 48 to 56 weeks, 76 patients had fewer than 400 copies of human immunodeficiency virus RNA per milliliter. In adults and adolescents, the median increase in the CD4 T-cell count from baseline to 12 months was 163 per cubic millimeter (interquartile range, 77 to 251 per cubic millimeter). In children, the median percentage of CD4 T cells rose from 13 percent at baseline to 26 percent (interquartile range, 22 to 36 percent) at 12 months. Treatment-limiting toxic effects occurred in 102 of the 910 adults and adolescents (11 percent) and 5 of the 94 children (5 percent). CONCLUSIONS: This report documents the feasibility of effective antiretroviral therapy in a large number of patients in an impoverished country. Overall, the outcomes are similar to those in the United States. These results provide evidence in support of international efforts to make antiretroviral therapy available to patients with AIDS in developing countries.
机译：背景：在海地，未经抗逆转录病毒治疗的患有后天免疫机能丧失综合症（AIDS）的成人和儿童的一年生存率约为30％。抗逆转录病毒疗法最近在海地和其他发展中国家可用。有关发展中国家抗逆转录病毒疗法疗效的数据有限。在这些国家中，热带疾病和结核病的高合并感染率以及营养不良和有限的实验室监测治疗可能会降低抗逆转录病毒疗法的疗效。方法：我们研究了自2003年3月开始在海地太子港开始治疗的首例1004例连续未曾接受抗逆转录病毒治疗的AIDS患者的抗逆转录病毒治疗的疗效。结果：在14个月内，对1004例患者（包括94名13岁以下的儿童）开始了三药抗逆转录病毒治疗。入学时，成人和青少年的CD4 T细胞中位数为131每立方毫米（四分位间距为55至211每立方毫米）;在儿童中，T细胞的中位数为13％，CD4阳性（四分位间距为8％至20％）。根据Kaplan-Meier生存分析，开始治疗一年后，有87％的成年人和青少年以及98％的儿童还活着。在100名成年和青少年患者的亚组中，这些患者进行了48至56周的随访，其中76名患者每毫升中的人类免疫缺陷病毒RNA拷贝数少于400。在成人和青少年中，从基线到12个月，CD4 T细胞计数的中位数增加为163每立方毫米（四分位数范围为77至251每立方毫米）。在儿童中，CD4 T细胞的中位数百分比从基线时的13％上升到12个月时的26％（四分位间距为22％至36％）。 910名成人和青少年中有102名（11％）和94名儿童中有5名（5％）出现了限制治疗的毒性作用。结论：本报告记录了在贫穷国家中对大量患者进行有效抗逆转录病毒治疗的可行性。总体而言，结果与美国相似。这些结果提供了证据，支持国际上为发展中国家的艾滋病患者提供抗逆转录病毒疗法的努力。

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