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联合抗白血病化疗与高效抗逆转录病毒疗法对非霍奇金淋巴瘤合并人类免疫缺陷病毒(HIV)感染患者的HIV病毒血症及基因分型的影响

Impact of concomitant antiblastic chemotherapy and highly active antiretroviral therapy on human immunodeficiency virus (HIV) viremia and genotyping in HIV-infected patients with non-Hodgkin lymphoma.

作者信息

Simonelli Cecilia, Zanussi Stefania, Cinelli Roberta, Dal Maso Luigino, Di Gennaro Giampiero, D'Andrea Monica, Nasti Guglielmo, Spina Michele, Vaccher Emanuela, De Paoli Paolo, Tirelli Umberto

机构信息

Division of Medical Oncology A, National Cancer Institute, Aviano, Italy.

出版信息

Clin Infect Dis. 2003 Sep 15;37(6):820-7. doi: 10.1086/377204. Epub 2003 Aug 28.

Abstract

We evaluated the replication and resistance patterns of human immunodeficiency virus (HIV) strains recovered from HIV-infected patients with non-Hodgkin lymphoma (NHL) who were receiving chemotherapy (CT) concomitant with highly active antiretroviral therapy (HAART). We analyzed virological response to HAART in 35 patients with HIV and NHL who were treated with a cyclophosphamide-doxorubicin-vincristine-prednisone chemotherapy regimen and HAART and the virological response in 26 HIV-infected patients with CD20 cell-positive NHL who were treated with rituximab and cyclophosphamide-doxorubin-etoposide therapy. Genotype and virtual phenotype analyses were performed at baseline and when virological failure occurred. Only 9 patients met the criteria for virological failure. Genotype and virtual phenotype analyses demonstrated that, during CT administration, new mutations might occur, but there were no significant changes in the preexisting resistance patterns. Our data show that combination therapy consisting of CT and HAART is feasible and that the virological response can be maintained in the majority of patients receiving this treatment.

摘要

我们评估了从接受化疗(CT)并同时接受高效抗逆转录病毒治疗(HAART)的非霍奇金淋巴瘤(NHL)HIV感染患者中分离出的人类免疫缺陷病毒(HIV)毒株的复制和耐药模式。我们分析了35例接受环磷酰胺-阿霉素-长春新碱-泼尼松化疗方案和HAART治疗的HIV合并NHL患者对HAART的病毒学反应,以及26例接受利妥昔单抗和环磷酰胺-阿霉素-依托泊苷治疗的CD20细胞阳性NHL的HIV感染患者的病毒学反应。在基线和病毒学失败发生时进行基因型和虚拟表型分析。只有9例患者符合病毒学失败标准。基因型和虚拟表型分析表明,在CT给药期间,可能会出现新的突变,但先前存在的耐药模式没有显著变化。我们的数据表明,CT和HAART联合治疗是可行的,并且在大多数接受这种治疗的患者中可以维持病毒学反应。

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