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Updated: May 13, 2025

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选择的并发症和ART转换的概率在PWH与不可检测的HIV-RNA:意大利的回顾性分析

Alessandro Cozzi-Lepri¹, Alessandro Tavelli^2,3, Lucia Taramasso⁴

¹CREME Centre, IGH University College London, London, UK.

The Journal of antimicrobial chemotherapy

|May 12, 2025

概括

新的伴随性疾病,如脂质障碍和病,在稳定病毒载量抑制的HIV (PWH) 患者中很常见. 管理这些条件可能会减少由于毒性的处理开关.

科学领域:

艾滋病毒医学艾滋病毒医学
临床流行病学临床流行病学
药物监督药物监督药物监督

背景情况:

抗逆转录病毒疗法 (ART) 改变了艾滋病毒管理,使病毒载量 (VL) 抑制成为可能.
然而,艾滋病毒感染者 (PWH) 的长期管理需要解决并发症和治疗持续时间.
了解并发症的发生率及其对治疗稳定性的影响对于优化护理至关重要.

研究的目的:

为了确定PWH中新并发症的发病率,稳定的VL≤50副本/毫升.
评估发生性失脂症 (DP),病 (EGFR下降) 和体重增加与治疗切换 (TS) 之间的关联.
评估这些并发症是否会因为毒性或简化而预测TS.

主要方法:

在Icona基金会研究队列中进行了六项嵌套病例控制研究.
主要结局是当前ART治疗方案的TS.
条件后勤回归模型被用来分析事件并发症和TS之间的关联.

主要成果:

脱脂症 (DP) 是最常见的并发症 (28.4%),其次是eGFR恶化和BMI升高.
没有任何因子与TS相关,以简化.
事件DP (aOR=2.49) 和eGFR下降>10mL/min/1.73m2 (aOR=1.51) 预测TS由于毒性.
基于增强蛋白酶抑制剂 (PI) 的疗法 (aOR=3.38) 时,DP和TS之间的关联更强烈.

结论:

DP和eGFR下降的发展与ART因抑制VL的PWH中毒性而停止的治疗有关.
预防或管理PWH脂质异常的干预措施可以减少ART变化.
减少ART切换可以保护未来的治疗选择,并改善PWH的长期结果.

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