在OPERA队列中使用现实世界多拉维林减肥:美国的队列研究
Karam Mounzer1, Laurence Brunet2, Michael Sension3
1Philadelphia FIGHT Community Health Centers, Philadelphia, LA, USA.
AIDS research and therapy
|June 21, 2025
概括
转换为多拉维林 (DOR),一种新的抗逆转录病毒药物,导致艾滋病毒感染者显著减肥. 这一发现很重要,因为大多数参与者超重或肥胖,体重增加是HIV药物的常见副作用.
科学领域:
- 艾滋病毒/艾滋病治疗治疗
- 药理学 药理学是指药理学的学科.
- 代谢健康 代谢健康
背景情况:
- 体重增加是某些针对HIV的抗逆转录病毒疗法 (ART) 的已知副作用,特别是整合酶抑制剂和tenofovir alafenamide (TAF).
- 多拉维林 (DOR) 是一种较新的非核酸逆转录酶抑制剂 (NNRTI),于2018年获得批准.
- 了解与DOR相关的体重变化对于管理HIV及其并发症至关重要.
研究的目的:
- 为了评估病毒学上被抑制的艾滋病毒感染者转换为含多拉维林 (DOR) 的抗逆转录病毒治疗方案的体重变化.
- 分析基于性别的体重变化模式,以及先前/同时使用 efavirenz (EFV),tenofovir disoproxil fumarate (TDF),整合酶抑制剂 (INSTI) 和 TAF.
主要方法:
- 基于美国的OPERA队列的分析,包括治疗经验丰富的艾滋病毒成年人.
- 纳入标准:病毒载量<50副本/毫升,并在2018年8月至2022年11月期间转换为含有DOR的疗法.
- 使用线性混合模型估计体重变化,结果按人口统计和治疗因素分层.
主要成果:
- 总体而言,388名参与者转向DOR,其中78%的人在基线时超重或肥胖.
- 在所有参与者中观察到统计学上显著的平均体重减轻0.80公斤/年.
- 男人和女人都经历了显著的体重减轻,女性的体重减轻率高于男性 (-1.67公斤/年) (-0.60公斤/年).
结论:
- 多拉维林 (DOR) 的使用与美国现实环境中的HIV病毒抑制个体的统计学上显著的体重减轻有关.
- 观察到的体重减轻并不能完全通过其他抗逆转录病毒药物的使用模式来解释.
- 这些发现具有临床意义,特别是在超重/肥胖个体和女性中,这表明DOR可能与其他ART相比具有有利的代谢特征.
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