艾滋病毒感染者患有失眠症状的脑功能参数的变化,从杜洛特格拉维尔转换为基于比克特格拉维尔的抗逆转录病毒疗法
Merle Henderson1,2, Kate Alford3,4, Samira Bouyagoub5
1Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK. m.henderson@imperial.ac.uk.
Journal of neurovirology
|August 20, 2025
概括
从多卢特格拉维尔 (DTG-ART) 转换为比克特格拉维尔 (BIC-ART) 改善了艾滋病毒和失眠患者的睡眠和生活质量. 这种开关还增强了大脑的功能连接,这表明它对大脑功能产生了积极的影响.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 睡眠障碍在艾滋病毒感染者中很常见,通常与整合酶链转移抑制剂 (INSTIs) (如 dolutegravir) 相关.
- 这项研究探讨了切换INSTIs对患有失眠的个体大脑功能的影响.
研究的目的:
- 评估艾滋病毒相关失眠患者大脑功能参数的变化,这些患者从含有杜洛特格拉维尔的ART (DTG-ART) 转换为比克特格拉维尔/埃姆特里西塔宾/特诺福维尔阿拉芬胺 (BIC-ART).
- 为了比较患者报告的结果 (PROs),功能磁共振成像 (fMRI) 数据,以及两种ART疗法之间的炎症生物标志物.
主要方法:
- 一项探索性研究随机选择了19名患有失眠 (失眠严重性指数>8) 的病毒学上受抑制的个体,要么继续使用DTG-ART,要么在120天内切换到BIC-ART.
- 在基线和120日使用PROs (睡眠,生活质量,ART症状),静止状态fMRI (默认模式和 Salience网络) 和血炎症生物标志物 (Neopterin,CXCL10,IL-6) 评估大脑功能.
- 基于种子的相关性 (SBC) 分析用于fMRI,检查连接性变化,PRO和生物标志物之间的相关性.
主要成果:
- 与DTG-ART组相比,BIC-ART组在失眠严重程度指数 (ISI),爱普沃思睡眠度量表 (ESS) 和简单形式-36身体功能 (SF36-PF) 评分上显示出显著的改善.
- BIC-ART与默认模式和 Salience 网络中的功能连接性增加有关,与改善的 ESS 和 SF36-PF 评分相关.
- 两组之间没有观察到可溶性炎症生物标志物的显著变化.
结论:
- 在艾滋病毒和失眠患者中,从DTG-ART切换到BIC-ART导致了自我报告的睡眠,生活质量和特定的休息状态fMRI网络的改善.
- 这些发现表明,与DTG-ART相比,BIC-ART在这个人群中可能对大脑功能和睡眠质量产生积极影响.
- 需要进一步的研究来证实这些探索性发现,并阐明底层机制.
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