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索福斯布维尔和里巴维林用于治疗艾滋病毒同时感染的患者的C型肝炎
Mark S Sulkowski1, Susanna Naggie2, Jacob Lalezari3
1Viral Hepatitis Center, Johns Hopkins University, Baltimore, Maryland.
JAMA
|July 20, 2014
概括
索福斯布维尔和利巴维林在艾滋病毒共感染的患者中有效治疗C型肝炎病毒 (HCV),实现高持续病毒学反应率,而不会对艾滋病毒疾病或治疗产生负面影响.
科学领域:
- 肝病学和传染病的研究
- 抗病毒疗法研究 抗病毒疗法研究
- 艾滋病毒/HCV并发感染管理
背景情况:
- 人类免疫缺陷病毒 (HIV) 同感染患者的C型肝炎病毒 (HCV) 治疗由于药物相互作用和基于干扰素的疗法而具有挑战性.
- 以前对HCV-HIV共感染的治疗选择有限,需要探索无干扰素治疗方案.
研究的目的:
- 评估由持续病毒学反应 (SVR) 衡量的索福斯布维尔和里巴维林在感染HCV和HIV的患者的疗效.
- 在目标人群中评估与这种口服,无干扰素治疗方案相关的安全性和不良事件.
主要方法:
- 这是一项开放的第三阶段试验,涉及223名患有HCV基因型1,2或3和同时感染HIV的患者.
- 患者接受了12周或24周的索福斯布维尔和基于体重的利巴维林,这取决于HCV基因型和治疗史.
- 资格要求稳定抗逆转录病毒治疗 (ART) 艾滋病毒或未经治疗的艾滋病毒,具有特定的CD4+T细胞计数.
主要成果:
- 在HCV基因型中观察到高SVR12率:76%的基因型1 (未经治疗),88%的基因型2和67%的基因型3 (未经治疗).
- 曾经接受过治疗的2或3型HCV基因型患者也表现出高SVR12率 (分别为92%和94%).
- 常见的不良事件包括疲劳,失眠和恶心;只有3%的患者因不良事件而停止治疗,对艾滋病毒状况没有影响.
结论:
- 口服,无干扰素组合的索福斯布维尔和里巴维林在患有HCV-HIV共感染的患者中显示出对HCV根除的高疗效.
- 这种疗法为HCV-HIV共感染个体提供了一个有前途的治疗选择,需要在不同人群中进行进一步的研究.
- 治疗耐受性良好,并没有对艾滋病毒疾病的进展或管理产生不利影响.
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