Manfredi R, Fiacchi P, Riolo U, Chiodo F
Dipartimento di Medicina Clinica Specialistica e Sperimentale, Università, Bologna.
Recenti Prog Med. 2000 Sep;91(9):425-9.
The administration of antiretroviral compounds to our cohort of HIV-infected patients was assessed since 1994, on the ground of some epidemiological, clinical, and therapeutic variables. During the six-year study period, a significant increase of mean prescription rate of overall anti-HIV agents was observed, with a nearly 10-fold rise of mean prescribed daily doses per 1,000 patients-year. In particular, lamivudine and indinavir represented the most frequently administered drugs, among nucleoside analogues and protease inhibitors, respectively. A significant increase of the percentage of HIV-infected patients undergoing combined antiretroviral therapy (79.3% in 1999), and the mean number of drugs prescribed per patient (3.02 in 1999), was concurrently detected. The progressive changes of antiretroviral therapy guidelines were responsible for a nearly 16-fold increase of expenditures directly related to antiretroviral drug administration in 1999 compared with 1994 (with over 41% of costs related to protease inhibitors). On the other hand, a substantial modification of HIV disease evolution occurred in our patient cohort in terms of absolute morbidity and mortality figures, as expressed by a drop of notified AIDS cases and AIDS-related deaths ranging from 2.5 to 5 times, during the considered period.
自1994年起，基于一些流行病学、临床和治疗变量，对我们这组感染HIV的患者使用抗逆转录病毒化合物的情况进行了评估。在为期六年的研究期间，观察到总体抗HIV药物的平均处方率显著增加，每1000患者年的平均规定日剂量增加了近10倍。特别是，拉米夫定和茚地那韦分别是核苷类似物和蛋白酶抑制剂中最常使用的药物。同时检测到接受联合抗逆转录病毒治疗的HIV感染患者百分比显著增加（1999年为79.3%），以及每位患者的平均用药数量（1999年为3.02种）。抗逆转录病毒治疗指南的逐步变化导致1999年与抗逆转录病毒药物给药直接相关的支出与1994年相比增加了近16倍（超过41%的成本与蛋白酶抑制剂有关）。另一方面，在我们的患者队列中，HIV疾病的演变在绝对发病率和死亡率方面发生了实质性变化，在所考虑的时期内，报告的艾滋病病例和与艾滋病相关的死亡人数下降了2.5至5倍。
