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[两种经典三联抗逆转录病毒治疗方案应用效果的观察性研究]

[Observational study on the efficacy of the application of two classical regimens of triple antiretroviral therapy].

作者信息

Eiros Bouza J M, Ortega Lafont M, Ortiz de Lejarazu R, Bachiller Luque P, de Luis Román D A

机构信息

Departamento de Microbiología. Hospital Clínico Universitario. Valladolid, Spain.

出版信息

An Med Interna. 2003 May;20(5):239-42.

Abstract

BACKGROUND

To compare the temporal evolution of viral load and CD4 parameters in two cohorts of HIV infected patients enrolled in classical triple antiretroviral regimens.

METHODS

Retrospective, observational, descriptive study of the proportions of patients reaching undetectable levels of viral load (VL) as well as the time necessary to get it. The two cohorts were as follows: 91 HIV patients on triple therapy with zidovudine plus lamivudine and indinavir (cohort A) versus 80 HIV patients with Stavudine plus Didanosine and Indinavir (cohort B).

RESULTS

The evolution of the patients in terms of percentages who reach undetectable VL was similar in the two therapeutic cohorts (75.8%for cohort A vs 73.8% for cohort B) along the duration of the study (four years). However, the mean time period needed to reach undetectable VL was different, 209 days (IC 95% 175-243 days) for patients in zidovudine plus lamivudine and indinavir and 330 days (IC 95% 263-396 days) for stavudine plus didanosine and indinavir regimen. The immunological status observed in the patients when reaching his first undetectable VL was significantly different. The proportion of patients with CD4 cells counts >200/mm3 in cohort A was 83.1% while for patients from cohort B was 65.4% (p=0.032).

CONCLUSIONS

This observational study from clinical settings seems demonstrate similar efficacy to reach undetectable VL with both classical triple antiretroviral therapies evaluated but a shorter delay of time to reach that virological situation for zidovudine plus lamivudine and indinavir regimen is reported.

摘要

背景

比较两组接受经典三联抗逆转录病毒疗法的HIV感染患者病毒载量和CD4参数的时间演变情况。

方法

对达到病毒载量(VL)不可检测水平的患者比例以及达到该水平所需时间进行回顾性、观察性、描述性研究。两组如下:91例接受齐多夫定加拉米夫定和茚地那韦三联疗法的HIV患者(A组)与80例接受司他夫定加去羟肌苷和茚地那韦治疗的HIV患者(B组)。

结果

在研究的四年期间,两个治疗组中达到不可检测VL的患者百分比的演变情况相似(A组为75.8%,B组为73.8%)。然而,达到不可检测VL所需的平均时间不同,接受齐多夫定加拉米夫定和茚地那韦治疗的患者为209天(95%置信区间175 - 243天),接受司他夫定加去羟肌苷和茚地那韦治疗方案的患者为330天(95%置信区间263 - 396天)。患者首次达到不可检测VL时观察到的免疫状态存在显著差异。A组中CD4细胞计数>200/mm³的患者比例为83.1%,而B组患者为65.4%(p = 0.032)。

结论

这项来自临床环境的观察性研究似乎表明,所评估的两种经典三联抗逆转录病毒疗法在达到不可检测VL方面具有相似的疗效,但报告显示齐多夫定加拉米夫定和茚地那韦治疗方案达到该病毒学状态的延迟时间更短。

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