Abstract:

Objective To explore the clinical efficacy and safety of early onset of highly active anti⁃AIDS retroviral therapy（HAART）in asymptomatic postpartum women with HIV infection. Methods A total of 104 asymptomatic HIV postpartum women with CD4 cells ≥ 400 /μL in Guangxi were selected. They received HIV prevention of mother⁃to⁃child transmission（PMTCT）during pregnancy and continued to receive HAART after delivery（52 patients in group A）or discontinued postpartum HAART treatment（52 patients in group B）. Regular follow ⁃ups were done postpartum 0 ~ 96 weeks to examine immune function，liver/kidney function and viral load and to analyze the effect of HAART on viral clearance，immune reconstitution，liver and kidney function in post⁃ partum women. Results CD4 count and CD4/CD8 between the two groups from 24 to 96 weeks were significantly different（P < 0.01）. CD4 and CD4/CD8 significantly increased in group A（P < 0.05）. After 72 weeks，CD4/CD8 ratio of group A was reversed（mean CD4/CD8）≥ 1.0）. In Group B，CD4 and CD4/CD8 decreased significantly at 24 weeks postpartum（P < 0.01），and gradually decreased with time. Group A had a higher rate of viral suppression （RNA < 20 copy/mL）with prolonged treat time（P < 0.01）. There was no significant difference（P > 0.05）in renal function（TBIL and CREA）between the two groups；but there was statistically significant difference（P < 0.05） in liver function（ALT and AST）from 48 to72 weeks that the levels of ALT and AST in group A were lower than those in group B and the AE of ALT and AST in group A was significantly lower than that in group B. Conclusion Early HAART is beneficial for virus removal and immune system reconstruction，promoting normal proportion of immune cell subpopulations. It is safe for liver and kidney in HIV asymptomatic women.

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