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最初的抗逆转录病毒治疗方案和心力衰竭的风险
Michael J Silverberg1,2,3, Noel Pimentel1, Wendy A Leyden1
1Division of Research, Kaiser Permanente Northern California, Oakland.
AIDS (London, England)
|November 15, 2023
概括
与非核糖逆转录酶抑制剂治疗方案相比,HIV感染者开始蛋白酶抑制剂抗逆转录酶治疗 (ART) 可能面临心力衰竭风险增加. 对其他ART类型需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 艾滋病毒感染者 (PWH) 患心力衰竭的风险较高.
- 初始抗逆转录病毒治疗 (ART) 方案对PWH心力衰竭风险的影响尚未完全理解.
研究的目的:
- 调查最初的ART疗法是否会影响艾滋病毒感染者的心力衰竭风险.
- 为了比较与蛋白酶抑制剂 (PI),非核糖逆转录酶抑制剂 (NNRTI) 和整合酶链转移抑制剂 (INSTI) 相关的心力衰竭风险.
主要方法:
- 一项队列研究包括13634名在2000年至2016年期间启动ART的PWH.
- 评估了不同ART类 (PI,NNRTI,INSTI) 和tenofovir与abacavir之间的心力衰竭风险.
- 使用逻辑边缘结构模型与反向概率权重计算,计算了危险比率.
主要成果:
- 该研究发现,基于蛋白酶抑制剂的ART与基于NRTI的ART相比,心力衰竭的风险更高 (1.8%与0.8%,P = 0.002).
- 在特诺福维尔和阿巴卡维尔之间没有观察到心力衰竭风险的显著差异.
- 对基于INSTI的疗法进行的有限的后续调查阻止了最终的结论.
结论:
- 与NNRTI相比,启动基于蛋白酶抑制剂的ART可能与艾滋病毒感染者的心力衰竭风险增加有关.
- 需要进行更长的随访时间的进一步研究,以评估基于INSTI和其他ART疗法对心力衰竭风险的评估.
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