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在二线ART中使用诺福维尔-胺-多卢特格拉维尔的长期病毒学结果

Jennifer K van Heerden^1,2, Ying Zhao^1,3, Claire M Keene^4,5

¹Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.

Southern African journal of HIV medicine

|May 13, 2025

概括

基于多卢特格拉维尔的抗逆转录病毒疗法 (ART) 是有效的二线艾滋病毒治疗,即使有先前的耐药性. 长期结局显示持续的病毒抑制,多卢特格拉维尔耐药性的发病率较低.

科学领域:

传染性疾病传染性疾病
病毒学病毒学
临床药理学临床药理学

背景情况:

针对HIV-1感染的二线抗逆转录病毒疗法 (ART) 需要仔细选择药物.
多卢特格拉维尔 (DTG) 是现代ART疗法的关键组成部分.
了解基于DTG的二线ART的长期结果至关重要,特别是在先前耐药性患者中.

研究的目的:

在接受二线ART的患者中,评估切换到tenofovir-lamivudine-dolutegravir (TLD) 的长期病毒学结果.
评估这种患者群体中耐药性的发生率,特别是对多卢特格拉维尔的耐药性.

主要方法:

进行了一项随机的,双盲的II期临床试验 (ARTIST).
两次连续HIV-1RNA水平≥1000拷贝/毫升的参与者在一线ART上被切换到TLD.
长期结果被评估到158周,包括病毒载量和耐药性测试.

主要成果:

很高比例的参与者 (78%在158周) 保持病毒载量<50拷贝/毫升,即使有先前存在的tenofovir和lamivudine耐药性.
杜洛特格拉维尔耐药性的出现很低,在2-3年后观察到约1%的参与者.
到第158周,病毒载量反弹发生在11%的参与者身上.

结论:

切换到TLD是一种有效的二线ART策略,适用于可检测HIV-1RNA的成年人和对较旧药物的实质性耐药性.
持续的病毒抑制可以在长期内实现,出现多卢特格拉维尔耐药性的风险很低.
这些发现支持在二线ART治疗方案中使用TLD来管理HIV-1感染.

关键词:

艾滋病病毒艾滋病病毒艾滋病病毒南非南非南非杜洛特格拉维尔 (Dolutegravir) 是一种严重的病毒.药物耐药性耐药性药物耐药性第二行第二行.十诺福维尔 - - 莱米丁 - - 多卢特格拉维尔.

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