Halliday: System and Function in Language : Selected Papers
Halliday: System and Function in Language : Selected Papers
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韩礼德：语言中的系统和功能：论文选
DOI：
10.1097/01.qai.0000163216.43510.cd
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发表时间：
1976
期刊：
影响因子：
--
通讯作者：
G. Kress
中科院分区：
文献类型：
--
作者：
M. Halliday;G. Kress
在临床实践中使用高效抗逆转录病毒疗法 (HAART) 的早期研究表明，病毒抑制率不理想。自此，HAART 治疗方案和使用 HAART 的专业知识不断发展，我们试图确定临床实践中对 HAART 的病毒学反应如何变化。我们对巴尔的摩护理中的 HIV 感染患者纵向队列中从 1996 年到 2002 年开始首次 HAART 治疗方案的所有患者进行了比较。将HIV RNA抑制至<400拷贝/mL有显着改善，6个月时从43.8%（1996年）到72.4%（2001-2002年），12个月时从60.1%（1996年）到79.9%（2001-2002年）（趋势P均<0.01）。 CD4 细胞反应也有显着改善。随着时间的推移，与单一 PI 方案相比，非核苷类逆转录酶抑制剂 (NNRTI) 或加强蛋白酶抑制剂 (PI) 方案的使用显着增加，并且未接受过抗逆转录病毒 (ARV) 治疗的患者数量也有所增加。从 1996 年到 2002 年，在实现抑制 HIV RNA 水平方面也存在显着的时间趋势，调整了 ARV 初治、特定的 HAART 方案、CD4 细胞计数、HIV-1 RNA 水平和人口因素。这表明病毒学反应的改善也可能归因于其他因素，例如更加注重药物依从性、改善的抗逆转录病毒药物耐受性和易于给药。
Early studies of highly active antiretroviral therapy (HAART) use in clinical practice suggested suboptimal rates of viral suppression. HAART regimens and expertise in the use of HAART have since evolved, and we sought to determine how virologic response to HAART has changed in clinical practice. We compared all patients who started a first HAART regimen from 1996 through 2002 in a longitudinal cohort of HIV-infected patients in care in Baltimore. There were significant improvements in suppressing HIV RNA to< 400 copies/mL, ranging from 43.8%(1996) to 72.4%(2001-2002) by 6 months and from 60.1%(1996) to 79.9%(2001-2002) by 12 months (both P< 0.01 for trend). There were also significant improvements in CD4 cell response. Over time, there was a significant increase in the use of a nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI) regimen compared with a single PI as well as an increase in the number of patients who were antiretroviral (ARV) naive. There was also a significant temporal trend from 1996 through 2002 in achieving a suppressed HIV RNA level, adjusting for being ARV naive, specific HAART regimen, CD4 cell count, HIV-1 RNA level, and demographic factors. This suggests that improved virologic response may also be attributable to other factors such as a greater focus on medication adherence, improved ARV tolerability, and ease of dosing.