The clinical outcome and immune reconstitution in 45 advanced AIDS patients undergoing highly active antiretroviral therapy for 12 months

Objective To investigate the efficacy and side effects of highly active antiretroviral therapy (HAART) in Chinese AIDS patients. Methods 45 antiretroviral drug-naive AIDS patients were enrolled and divided into two groups by their baseline CD4 count 100/μl or≥100/μl. Clinical, virological and immunological outcomes as well as side effects were followed at baseline and at the end of month 1,3,6,9, 12 after receiving HAART. Results Among the 45 HIV/AIDS patients included, by the end of 12 months of HAART, the plasma viral load ( VL) got a mean reduction by 2. 8 lg copies/ml, CD4 count had a mean gain of 187/μl, among which the naive phenotype increased by 68/μl and the memory phenotype by 119/μl. The CD4+CD28+T cell percentage went up from (62. 5±25. 8)% to (82. 6±15. 6)% (P 0. 001) ; and there was a significant reduction of CD8+ T-cell activation. In the 31 patients with their baseline CD4 count 100/μl, 11 had a VL 50 copies/ml, and 14 had fluctuations in their VL; while in 14 patients with their baseline CD4 count≥100/μl, 10 had a VL 50 copies/ml and 2 had fluctuations in their VL, respectively, with statistic significance between the two groups. CD4 count showed a bi-phase increase during HAART and there was significant positive correlation between the change of CD4 count and plasma VL. Throughout the 12 months of HAART,39 patients had gastrointestinal side effects, 15 peripheral neuritis, 3 hepatic lesions, 4 hematological side effects and 1 renal calculus. 9 patients had adjustment of their initial therapy because of side effects. Conclusions Immune reconstitution as well as significant therapeutic effect was observed in advanced Chinese AIDS patients after HAART. Side effects were common during HAART, so close clinical attention is needed.