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艾滋病毒感染者和末期病患者的抗逆转录病毒治疗
Matthew Spencer1, Christopher Pieri2, Lisa Hamzah3
1King's College Hospital NHS Foundation Trust.
AIDS (London, England)
|January 28, 2025
概括
双重/未增强的抗逆转录病毒疗法 (ART) 对艾滋病毒患者具有末期病 (ESKD) 有效. 较高剂量的拉米丁耐受性良好,支持在所有功能水平上使用多卢特格拉维尔/拉米丁.
科学领域:
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 末期脏病 (ESKD) 患者的抗逆转录病毒治疗 (ART) 管理需要仔细考虑药物剂量和治疗方案的选择.
- 在ESKD人群中优化ART对于保持病毒抑制和预防与药物相关的毒性至关重要.
研究的目的:
- 要总结抗逆转录病毒疗法 (ART) 在末期病 (ESKD) 患者的使用情况.
- 在这个人群中评估双重/未增强ART疗程和不同剂量的核酸/核酸逆转录酶抑制剂 (NRTI) 的疗效和耐受性.
主要方法:
- 对157名艾滋病毒感染者和ESKD (透析,移植或eGFR<15mL/min/1.73m2) 的参与者的横截面分析.
- 对ART疗法进行描述性分析,重点关注双重/无增强疗法和NRTI剂量.
- 对HIVRNA水平的评估和与估计的淋巴细胞过率 (eGFR) 相关的拉米武丁剂量调整.
主要成果:
- 37%的参与者使用双重/未增强型ART疗法,主要是多卢特格拉维尔/拉米丁,达到与三重ART相似的HIV抑制率.
- 77%的参与者使用了高于推的 lamivudine 剂量;32%的参与者使用了全剂量 lamivudine (300 mg) 的 eGFR <30 mL/min/1.73 m2.
- 三重ART治疗的两名参与者在双重/未增强ART治疗之前有病毒学失败;目前没有任何降低剂量的拉米武丁使用者报告过先前的毒性.
结论:
- 双重/未增强的ART,包括多卢特格拉维尔/拉米丁,在ESKD患者中显示出强大的病毒疗效.
- 较高的拉米武丁剂量,包括全剂量,耐受性良好,这表明固定剂量的杜洛特格拉维尔/拉米武丁 (300毫克) 组合适用于整个eGFR频谱.
- 杜洛特格拉维尔/拉米丁固剂组合需要在ESKD群体中进一步研究其作为单片药片治疗方案的潜力.
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