亚巴卡维尔替代核类型在艾滋病毒缩患者:一个随机试验
Andrew Carr1, Cassy Workman, Don E Smith
1HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Sydney, 2010 Australia. acarr@stvincents.com.au
JAMA
|July 4, 2002
概括
从斯塔夫丁或齐多夫丁转换为阿巴卡维尔改善了HIV患者的四肢脂肪. 然而,主观脂肪缩的严重程度没有改善,这表明需要更长的治疗时间.
科学领域:
- 艾滋病毒/艾滋病研究研究
- 药理学 药理学是指药理学的学科.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 周围脂肪缩是抗逆转录病毒疗法 (ART) 对人类免疫缺陷病毒 (HIV) 感染的常见并发症.
- 这种情况往往与核类模拟疗法的持续时间和类型有关,可能涉及线粒体损伤.
- 目前,没有确定的治疗 lipoatrophy 存在,虽然阿巴卡维尔,一个核酸类比,显示潜在的线粒体毒性降低.
研究的目的:
- 评估用阿巴卡维尔取代斯塔夫丁或齐多夫丁是否可以改善与艾滋病毒相关的脂肪缩.
- 评估这种替代是否会影响控制HIV复制.
- 确定脂肪分布和代谢参数的客观和主观变化.
主要方法:
- 一项随机的,开放的,为期24周的研究在澳大利亚和英国的17家艾滋病毒门诊进行.
- 接受斯塔夫丁或齐多夫丁治疗的111名中度至重度脂肪缩的成年人被随机分配到转换为阿巴卡维尔或继续他们目前的ART.
- 主要终点是用双能X射线吸收计测量的四肢脂肪质量;次要终点包括HIVRNA水平,脂质变异严重程度和代谢概况.
主要成果:
- 与斯塔夫丁/齐多夫丁组相比,阿巴卡维尔组的四肢脂肪质量显著增加 (0.39 vs 0.08 公斤).
- 随着阿巴卡维尔的使用,大腿,手臂和腹部区域的皮下脂肪显著增加.
- 转换为阿巴卡维尔并没有显著影响血HIVRNA水平,而对脂质缩小的主观评估也没有得到改善.
结论:
- 在24周内从斯塔夫丁或齐多夫丁转换为阿巴卡维尔,导致艾滋病毒感染的成年人体内肢体脂肪的适度,客观测量的改善.
- 主观临床缩在研究期间没有消失,这表明可能需要更长时间的治疗才能明显改善.
- 需要进行进一步的长期随访研究,以确定阿巴卡维尔在治疗与艾滋病毒相关的脂肪缩方面的持续有效性和安全性.
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