Opravil M, Hirschel B, Bucher H C, Lüthy R
Division of Infectious Diseases and Hospital Epidemiology, University Hospital, Zurich, Switzerland.
Int J STD AIDS. 1999 Jun;10(6):369-75.
The efficacy and toxicity of interferon-alpha2a (9MU/d) and bleomycin (15 mg every 2 weeks), each combined with zidovudine (2x250 mg/d), was compared in a randomized study in 26 men with progressing AIDS-related Kaposi's sarcoma (KS). The median CD4 count was 113/microl. Complete or partial response was achieved in one (8%) of 12 evaluable patients on interferon and in 2 (20%) of 10 patients on bleomycin (P = 0.43) during 4.7 and 5.3 months of treatment, respectively. The tolerability was comparable. During extended follow up, survival time was 24 and 13 months in the interferon and bleomycin arm, respectively. In a multivariate Cox regression analysis, CD4 lymphocytes <200/microl (relative risk 3.74; 95% CI: 1.30-10.8) and randomization to interferon (relative risk 0.37; 95% CI: 0.15-0.90) were significantly predictive of mortality. New AIDS-related events occurred more frequently in patients who had received bleomycin. The antiviral activity of interferon-alpha or the chemotherapy-mediated increase in the risk for opportunistic infections may explain these differences.
在一项针对26名患有进展性艾滋病相关卡波西肉瘤（KS）的男性患者的随机研究中，比较了干扰素α2a（9MU/天）和博来霉素（每2周15mg）分别联合齐多夫定（2×250mg/天）的疗效和毒性。CD4计数中位数为113/μl。在治疗的4.7个月和5.3个月期间，12名接受干扰素治疗的可评估患者中有1名（8%）获得完全或部分缓解，10名接受博来霉素治疗的患者中有2名（20%）获得完全或部分缓解（P = 0.43）。耐受性相当。在延长随访期间，干扰素组和博来霉素组的生存时间分别为24个月和13个月。在多变量Cox回归分析中，CD4淋巴细胞<200/μl（相对风险3.74；95%CI：1.30 - 10.8）以及随机分配至干扰素组（相对风险0.37；95%CI：0.15 - 0.90）是死亡率的显著预测因素。接受博来霉素治疗的患者发生新的艾滋病相关事件更为频繁。干扰素α的抗病毒活性或化疗介导的机会性感染风险增加可能解释了这些差异。
