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心脏移植和人类免疫缺陷病毒-导航药物相互作用:一个案例报告
Thamer A Almangour1, Preston T Skersick2, Amanda Corbett2
1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. talmangour@ksu.edu.sa.
AIDS research and therapy
|August 11, 2023
概括
心脏移植对于患有人类免疫缺陷病毒 (HIV) 的人来说是可行的. 抗逆转录病毒疗法 (ART) 和免疫抑制剂之间的药物相互作用的仔细管理对于成功的长期结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 移植医学 移植医学
背景情况:
- 抗逆转录病毒疗法 (ART) 改善了人类免疫缺陷病毒 (HIV) 患者的生存率,将重点转移到器官功能障碍等并发症.
- 心脏移植 (HT) 对末期心力衰竭 (HF) 有效,但存在关于ART和免疫抑制剂之间的药物相互作用 (DDI) 的担忧.
研究的目的:
- 报告一个接受了心脏移植的艾滋病毒患者的长期结果.
- 强调ART和HT后的免疫抑制疗法之间的复杂药物相互作用的管理.
主要方法:
- 一名58岁的HIV-1阳性男性患有缺血性心肌病,接受了 орто托普性HT.
- 修改了ART治疗方案以避免DDI;免疫抑制包括塔克罗利和甲酸莫菲蒂尔.
- 长期随访 (76个月) 监测心脏功能,病毒载量,CD4计数和移植后并发症.
主要成果:
- 患者保持正常的心脏功能和不可检测的HIV-1RNA水平,CD4计数>200细胞/mm3.3.
- 在ART和免疫抑制剂之间管理DDI.
- 经历了一次无症状的急性细胞排斥,前列腺腺癌,基底细胞癌,心脏全移植血管病变和外围神经病变.
结论:
- 在精心挑选的患者中,HIV-1阳性状态不应是HT的禁忌.
- 在HT前的DDI评估和长期监测并发症和恶性瘤对于成功的结果至关重要.
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