替代的多卢特格拉维尔剂量策略与用于治疗潜在结核病的同时使用的里法丁
Addison Taylor1, Elizabeth Winthrop1, Patricia Pecora Fulco1
1Virginia Commonwealth University Health System, Richmond, VA, USA.
International journal of STD & AIDS
|September 13, 2023
概括
一个案例研究突出了艾滋病毒患者里法丁和多卢特格拉维尔之间的药物相互作用. 在结核病治疗期间调整多洛特格拉维尔剂量对于维持病毒抑制至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病研究研究
背景情况:
- 在感染人体免疫缺陷病毒 (HIV) 的人群中,管理像结核病这样的并发感染需要仔细考虑药物相互作用.
- 抗逆转录病毒疗法 (ART) 方案,特别是包括整合酶链转移抑制剂 (如多卢特格拉维尔) 的疗法,是艾滋病毒管理的核心.
- 潜伏性结核病感染 (LTBI) 需要治疗,通常使用利法素,这些药物已知与各种药物相互作用.
研究的目的:
- 在HIV阳性患者中报告里法丁和多卢特格拉维尔之间的药物相互作用病例.
- 为了研究利法丁对多卢特格拉维尔最低度和艾滋病毒病毒载量的影响.
- 建议在与利法丁联合使用时考虑杜洛特格拉维尔的剂量.
主要方法:
- 一个53岁的艾滋病毒感染者和新诊断的潜在结核病病例报告.
- 开始每周一次的利法丁/伊索尼亚齐德/皮里多克辛治疗,持续12周,同时服用固剂组合抗逆转录病毒疗法.
- 在里法丁治疗期间,在晚上添加额外50毫克的多卢特格拉维尔剂量,并监测多卢特格拉维尔的最低度和艾滋病毒病毒载量.
主要成果:
- 同时使用利法丁和杜洛特格拉维尔治疗导致杜洛特格拉维尔的最低度降低.
- 在联合治疗期间,观察到HIV病毒载量的轻微反弹.
- 在完成利法丁治疗并恢复标准的多卢特格拉维尔剂量后,度正常化,病毒载量变得无法检测.
结论:
- 由于酶诱导,利法丁显著降低了多洛特格拉维尔的最低度.
- 在并发治疗期间,可能需要增加多卢特格拉维尔剂量以维持病毒抑制.
- 目前的指导方针不涉及与利法丁调整多卢特格拉维尔的剂量,需要进一步的研究和更新的建议.
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