Lobato-Mendizábal E, Ruiz-Argüelles G J
Hospital Universitario de Puebla, México.
Rev Invest Clin. 1992 Apr-Jun;44(2):161-8.
A group of 26 patients (18 males and 8 females) infected with HIV (42% through sexual route and 58% through blood/blood products transfusion) was prospectively studied to assess the efficacy of low doses (300 mg/day) of AZT combined (n = 15) or not (n = 11) with ACV (600 mg/day). According to CDC stages, 12% were in stage II, 73% in stage III and 15% in stage IV. Patients were followed for a maximum of 156 weeks. An objective response was observed in all patients who improved significantly in: performance status (Karnofsky 74.5 versus 97.6%, p less than 0.01), weight 58.9 versus 68.6 kg, p less than 0.01), and absolute CD4 T cell count (329/microL versus 480/microL, p less than 0.01). The levels of hemoglobin dropped after treatment (12.8 versus 11.5, p less than 0.01). Median survival was 114 weeks for all the group. With the exception of granulocytopenia in 42% of patients treated with AZT + ACV versus only in 22% of those treated solely with AZT (p = 0.02), similar effects were recorded in both treatments: 114-week survival was 60% for those treated solely with AZT, whereas 156-week survival was 93% for those treated with AZT + ACV (p NS), but the response was better for the combination of antivirals in the group of patients with more than 200 CD4 cells/microL at diagnosis as compared with those with less than 200 cells (110-week survival of 100% versus 50% respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
对一组26例感染HIV的患者(18例男性和8例女性,42%通过性途径感染,58%通过输血/血液制品感染)进行前瞻性研究,以评估低剂量(300毫克/天)齐多夫定联合(n = 15)或不联合(n = 11)阿昔洛韦(600毫克/天)的疗效。根据美国疾病控制与预防中心(CDC)分期,12%处于II期,73%处于III期,15%处于IV期。患者随访最长156周。所有患者在以下方面均有显著改善,观察到客观反应:体能状态(卡诺夫斯基评分从74.5%提高到97.6%,p<0.01)、体重从58.9千克增加到68.6千克,p<0.01)以及绝对CD4 T细胞计数(从329/微升增加到480/微升,p<0.01)。治疗后血红蛋白水平下降(从12.8降至11.5,p<0.01)。整个组的中位生存期为114周。除了接受齐多夫定+阿昔洛韦治疗的患者中有42%出现粒细胞减少,而仅接受齐多夫定治疗的患者中只有22%出现粒细胞减少(p = 0.02)外,两种治疗记录到相似的效果:仅接受齐多夫定治疗的患者114周生存率为60%,而接受齐多夫定+阿昔洛韦治疗的患者156周生存率为93%(p无统计学意义),但与诊断时CD4细胞/微升少于200的患者相比,诊断时CD4细胞/微升多于200的患者组中抗病毒药物联合治疗的反应更好(分别为110周生存率100%对50%)。(摘要截断于250字)