用持续输注阿西克洛维尔治疗耐药的简单疹病毒
J P Engel1, J A Englund, C V Fletcher
1Department of Medicine, University of Minnesota, Minneapolis.
JAMA
|March 23, 1990
概括
在艾滋病患者中,抗乙克洛维尔简疹病毒2型前列炎被高剂量持续输液乙克洛维尔有效治疗. 这种方法克服了与提米丁激酶改变相关的病毒耐药性,提供了安全的门诊选择.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 获得性免疫缺陷综合征 (艾滋病) 患者容易发生严重的机会性感染.
- 简单疹病毒2型 (HSV-2) 可以导致严重的性直肠炎,特别是在免疫力低下的人群中.
- 在HSV-2中,阿西克洛维尔耐药性是一个日益严重的临床问题,通常与病毒胺基酶突变有关.
研究的目的:
- 评估高剂量持续输注阿西克洛维尔在治疗艾滋病患者抗阿西克洛维尔抗性HSV-2性直肠炎的疗效和安全性.
- 调查这些患者的HSV-2分离体中阿西克洛维尔耐药性的机制.
主要方法:
- 两名艾滋病患者因抗阿西克洛维尔抗性HSV-2而患有严重的性直肠炎.
- 治疗涉及6周的高剂量,连续输注阿西克洛维尔 (1.52.0毫克/公斤/小时).
- 分析了病毒分离物对阿西克洛维尔耐药性机制的分析,重点是提米丁激酶活性.
主要成果:
- 连续输液方案的两名患者都取得了成功的治疗结果.
- 病毒分离物由于提米丁激酶的改变而表现出抗性:一种分离物缺乏活性,另一个分离物改变了基质特异性.
- 持续输液治疗是安全的,在门诊环境中耐受良好,并定期监测.
结论:
- 高剂量,连续输液阿西克洛维尔是一种有效的治疗艾滋病患者抗阿西克洛维尔抗性HSV-2性直肠炎.
- 了解特定的胺基因酶突变对于管理阿西克洛维尔耐药性至关重要.
- 随时输注阿西克洛维尔的门诊治疗是一种可行的和安全的治疗策略.
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