在服用抗发作药物的患者中对艾滋病毒进行暴露前和暴露后预防
Wesley T Kerr1,2,3, Barry Gidal4, Sean N Avedissian5
1Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
Epilepsy currents
|September 23, 2024
概括
本综述详细介绍了抗发作药物 (ASM) 和艾滋病毒暴露前预防 (PrEP) 或暴露后预防 (PEP) 之间的药物相互作用. 诱导酶的ASM可以降低PrEP/PEP的有效性,而利托纳维尔可能会影响lamotrigine水平.
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
- 神经学 神经学
背景情况:
- 预防艾滋病毒越来越依赖于暴露前和暴露后预防 (PrEP/PEP).
- 与抗逆转录病毒疗法 (ARTs) 同时处方抗发作药物 (ASM) 存在挑战,因为自2012年以来,有许多新的药物选择.
- 历史上的挑战包括病毒学失败,获得医疗保健的障碍,以及与艾滋病毒和发作相关的耻辱.
研究的目的:
- 审查基于指南的PrEP/PEP和ASM之间的药理动力学 (PK) 相互作用.
- 为了识别这些药物类别的重叠副作用.
- 为管理联合治疗和减少艾滋病毒风险提供临床资源.
主要方法:
- 关于药物相互作用的现有数据的叙述性审查.
- 专注于PrEP/PEP和特定的ASM (诱导酶,氨酸,拉莫特里金) 之间的药理学相互作用.
- 对重叠的不良事件的分析.
主要成果:
- 诱导酶的ASM可以降低含有特诺福维尔的PrEP和PEP成分 (dolutegravir,raltegravir,ritonavir) 的血清水平,这可能会影响HIV治疗的疗效.
- 里托纳维尔在PEP中可能会显著降低拉莫特里金水平,增加突破风险和治疗后皮肤反应.
- 常见的重叠副作用包括骨质疏松症,肝毒性和胃肠道问题.
结论:
- 临床医生需要意识到PK相互作用和重叠的副作用,当同时处方ASM和PrEP/PEP.
- 管理策略对于确保成功治疗发作和有效预防艾滋病毒至关重要.
- 需要进一步的研究来解决这一领域的知识差距和未满足的需求.
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