艾滋病毒对杜洛特格拉维尔的耐药性因同时使用的药物而异
Ingrid A Beck1, Ceejay L Boyce1, Marley D Bishop1
1Seattle Children's Research Institute, Seattle, Washington, USA.
概括
当与某些核酸逆转录酶抑制剂一起使用时,对杜洛特格拉维尔的HIV耐药性更为常见. 具体来说,包括拉米武丁与齐多武丁或阿巴卡维尔在内的组合药物显示出更高的抗药率.
科学领域:
- 病毒学
- 传染性疾病
- 药理学
背景情况:
- 多卢特格拉维尔是HIV治疗的关键整合酶抑制剂.
- 了解影响杜洛特格拉维尔耐药性的因素对于优化抗逆转录病毒治疗至关重要.
- 核逆转录酶抑制剂 (NRTIs) 的细胞内半衰期不同,可能会影响组合治疗的疗效.
研究的目的:
- 调查NRTI细胞内半衰期与HIV-多卢特格拉维尔耐药性的发生频率之间的关联.
- 在不同NRTI脊柱中比较HIV感染者的杜洛特格拉维尔耐药率.
主要方法:
- 在4个队列 (总N=660) 中,对183名病毒性参与者的数据 (HIV RNA≥200副本/ ml) 进行了多变量分析.
- 主要评估结果是杜洛特格拉维尔耐药性的发生.
- 为了比较不同NRTI组合的抗性频率,计算了几率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 总的来说,在21名参与者 (11. 5%) 中观察到杜洛特格拉维尔耐药性.
- 与杜洛特格拉维尔+拉米丁+齐多夫丁 (OR=19. 4, 95% CI 5.1-74. 3) 和杜洛特格拉维尔+拉米丁+阿巴卡维尔 (OR=5. 4, 95% CI 1. 1- 25. 8) 相关的耐药性显著更高.
- 这些抗药率与多卢特格拉维尔+拉米丁+特诺福维尔组合进行了比较.
结论:
- 当与具有较短细胞内半衰期的NRTI (如齐多夫丁和阿巴卡维尔) 同时使用时,艾滋病毒耐药性更为频繁.
- 杜洛特格拉维尔与拉米武丁和特诺福维尔的组合似乎与杜洛特格拉维尔耐药性的风险较低有关.
- 这些发现凸显了NRTI骨干选择在预防艾滋病毒耐药性的出现方面的重要性.
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