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从 efavirenz 转换为使用 cobicistat 增强的 elvitegravir 后,胰岛素抵抗增加
Richard Taylor Pickering1,2, Archana Asundi1,2, Alex Olson1
1Boston University School of Medicine, Boston, MA, USA.
Antiviral therapy
|February 15, 2025
概括
整合酶链转移抑制剂 (INSTIs) 可能会导致艾滋病毒感染者的体重增加. 转换为以埃尔维特格拉维尔为基础的疗法增加了胰岛素抵抗和乳酸水平,独立于体重增加.
科学领域:
- 艾滋病毒/艾滋病治疗治疗
- 代谢障碍 代谢障碍 代谢障碍
- 药理学 药理学是指药理学的学科.
背景情况:
- 整合酶链转移抑制剂 (INSTIs) 与艾滋病毒感染者的体重增加有关.
- 与INSTI相关的体重增加背后的机制尚未完全理解.
- 以前的研究表明,INSTIs可能会影响代谢健康.
研究的目的:
- 调查切换到含有INSTI的抗逆转录病毒疗法所产生的代谢影响.
- 为了比较埃尔维特格拉维尔和拉尔特格拉维尔治疗方案之间的代谢变化.
- 探索INSTIs,体重增加和代谢参数之间的关系.
主要方法:
- 一个前性队列研究的二次分析.
- 艾滋病毒感染的参与者从埃法维伦兹转换为埃尔维特格拉维尔或拉尔特格拉维尔.
- 血样本分析了勒丁,阿迪波内克丁,胰岛素和乳酸.
- 收集了禁食脂质,葡萄糖和人类测量数据.
主要成果:
- 转换为埃尔维特格拉维尔在8周后使胰岛素抵抗 (HOMA-IR) 增加了20%.
- 增加的胰岛素抵抗与更高的血乳酸水平有关.
- 体重增加发生在队列中,但不是胰岛素抵抗的主要驱动因素.
结论:
- 基于INSTI的疗法可能会导致艾滋病毒感染者的体重增加.
- 与拉尔特格拉维尔相比,含有埃尔维特格拉维尔的疗法显示胰岛素抵抗和乳酸的增加.
- 埃尔维特格拉维尔可能会导致艾滋病毒感染者代谢障碍.
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