对HIV-1的长效注射剂的安全性和有效性:系统性审查和元分析
Wenjing Wang1, Shengnan Zhao1, Yaxin Wu1
1Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
JMIR public health and surveillance
|July 27, 2023
概括
长效抗逆转录病毒药物 (LA-ARV),如卡博特格拉维尔和里尔皮维林,其疗效与每日口服的HIV-1治疗药物相当. 这些LA-ARVs耐受性良好,并改善了对HIV预防和治疗的坚持.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 艾滋病毒-1感染仍然是一个全球健康挑战,需要有效的治疗和预防策略.
- 目前的抗逆转录病毒疗法需要每天坚持高水平,这对一些人来说构成了挑战.
- 长效抗逆转录病毒药物 (LA-ARVs) 提供了一个有希望的替代方案,以改善HIV-1管理中的药物坚持.
研究的目的:
- 评估长效卡博特格拉维尔 (CAB-LA) 和长效里尔皮维林 (RPV-LA) 在HIV-1预防和治疗中的安全性和有效性.
- 为了比较LA-ARV与现有的口服抗逆转录病毒药物和安慰剂的有效性.
- 评估患者对LA-ARV配方的偏好和耐受性.
主要方法:
- 在PubMed,Embase和Cochrane图书馆进行了系统的文献搜索,截至2022年11月12日.
- 包括12项试验 (7项预防,5项治疗),涉及10,957名患者,分析了疗效和安全数据.
- 使用固定或随机效应模型的元分析合成了数据,并对CAB-LA+RPV-LA进行了子组分析.
主要成果:
- 长效卡博特格拉维尔 (CAB-LA) 在预防HIV-1方面表现出优越的疗效,相比于诺福维尔二松醇烟酸-emtricitabine.
- CAB-LA+RPV-LA的疗效与每日口服药物治疗HIV-1的疗效相当,达到高的病毒抑制率,长达5年.
- 虽然与药物相关的不良事件在CAB-LA+RPV-LA中更频繁,但注射部位反应很常见,但轻微,并且随着时间的推移而减少;超过85%的患者更喜欢LA-ARVs.
结论:
- 长效抗逆转录病毒药物 (LA-ARVs) 在HIV-1预防和治疗方面表现出良好的安全性和耐受性.
- CAB-LA为HIV-1预防提供了增强的疗效,而CAB-LA+RPV-LA提供了持续的病毒抑制,可能减少传播.
- LA-ARVs是艾滋病毒管理的可行选择,尽管需要进一步的试验来确认长期疗效.
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