Prescrire Int. 2005 Apr;14(76):54-6.
(1) The current first-line treatment for HIV infection is a combination of at least two nucleoside (or nucleotide) inhibitors of HIV reverse transcriptase, and one non nucleoside inhibitor or at least one HIV protease inhibitor. (2) Emtricitabine is the eighth nucleoside/nucleotide inhibitor to be marketed in France. It has a similar chemical structure to lamivudine. (3) Evaluation of emtricitabine use in adults contains data from four comparative trials, two in treatment-naive patients and two in patients who were already receiving a virologically effective treatment. Emtricitabine combination therapy was no more effective than lamivudine combination therapy on either viral load or the CD4+ lymphocyte count. (4) Only non comparative trials are available in children. (5) In clinical trials, the adverse effects of emtricitabine were similar to those of lamivudine, including headache, pain, fatigue, fever, abdominal pain, nausea, vomiting, and diarrhea. (6) Viral strains resistant to emtricitabine are also resistant to lamivudine, and vice versa. (7) Emtricitabine, like other nucleoside inhibitors (lamivudine, didanosine, tenofovir), can be taken once a day by mouth. (8) In practice, emtricitabine is indistinguishable from lamivudine and does not offer any advance for patients living with HIV/AIDS.
（1）目前针对HIV感染的一线治疗方案是至少两种HIV逆转录酶核苷（或核苷酸）抑制剂与一种非核苷抑制剂或至少一种HIV蛋白酶抑制剂的联合使用。（2）恩曲他滨是在法国上市的第八种核苷/核苷酸抑制剂。它的化学结构与拉米夫定相似。（3）对成人使用恩曲他滨的评估包含来自四项比较试验的数据，两项针对初治患者，两项针对已经接受病毒学有效治疗的患者。恩曲他滨联合疗法在病毒载量或CD4 +淋巴细胞计数方面并不比拉米夫定联合疗法更有效。（4）关于儿童只有非比较性试验。（5）在临床试验中，恩曲他滨的不良反应与拉米夫定相似，包括头痛、疼痛、疲劳、发热、腹痛、恶心、呕吐和腹泻。（6）对恩曲他滨耐药的病毒株对拉米夫定也耐药，反之亦然。（7）恩曲他滨与其他核苷抑制剂（拉米夫定、去羟肌苷、替诺福韦）一样，可以每天口服一次。（8）在实际应用中，恩曲他滨与拉米夫定难以区分，对感染HIV/AIDS的患者没有任何优势。
