BMC Infectious Diseases:从蛋白酶抑制剂转换为利匹韦林或整合酶抑制剂后患者血脂得到改善

2019-03-17 不详 网络

血脂异常是艾滋病病毒感染者中的一种非传染性合并症。本研究旨在评估从依法韦仑(EFV)或蛋白酶抑制剂/利托那韦(PI/r)为基础的方案转换为利匹韦林(RPV)或基于每日一次的整合酶抑制剂的方案对患者血脂的影响。我们分析了SCOLTA预期数据库中的数据。如果他们从EFV转为多替拉韦(EFV-DTG组),埃替格韦(EFV-EVG)或RPV(EFV-RPV),从PI/r转为DTG(PI/r-DTG),从P

血脂异常是艾滋病病毒感染者中的一种非传染性合并症。本研究旨在评估从依法韦仑(EFV)或蛋白酶抑制剂/利托那韦(PI/r)为基础的方案转换为利匹韦林(RPV)或基于每日一次的整合酶抑制剂的方案对患者血脂的影响。

我们分析了SCOLTA预期数据库中的数据。如果他们从EFV转为多替拉韦(EFV-DTG组),埃替格韦(EFV-EVG)或RPV(EFV-RPV),从PI/r转为DTG(PI/r-DTG),从PI/r转为EVG(PI/r-EVG),或从PI/r转为RPV(PI/r-RPV),则所有HIV-RNA <50拷贝/ml的患者在接受两种NRTI + EFV或PI/r治疗时均被纳入。在基线,6个月和1年时比较总胆固醇(TC),TC / HDL比率,LDL-胆固醇(LDL)和甘油三酯(TG)。通过一般线性模型进行组间比较。

结果,研究招募了499名患者,24.9%为女性,平均年龄为47.3岁(±10.1)。根据ART转换,11.4%为EFV-DTG组,3.9%为EFV-EVG组,23.9%为EFV-RPV组,17.6%为PI/r-DTG组,17.8%为PI/r -EVG组,25.5%为PI/r -RPV组。校正分析后,除EFV-DTG外其他组TC均显著降低,除EFV-DTG和EFV-EVG组外,其他组TC / HDL均明显降低,但是仅有在转换为RPV时TG显著降低(EFV-RPV和PI/r- RPV)。同一变量基线水平较高的患者TC、TC/HDL、LDL和TG的一年下降较高(p <.0001)。

总之,在SCOLTA研究中,从PI/r方案转换为其他的治疗方案均有降低患者的血脂水平的趋势,但是只有使用RPV替代EFV时具有持续的降脂作用。

原始出处:

Lucia Taramasso, Paola Tatarelli, et al., Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or oncedaily integrase inhibitors: results from a large observational cohort study (SCOLTA). BMC Infectious Diseases (2018) 18:357

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    2020-01-10 jklm09
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    2019-05-15 canlab
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    2019-03-19 Tamikia
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    2019-03-19 dongjia2015
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    2019-03-17 orangesking

    0