Tin Ei Ei, Bowonwatanuwong Chureeratana, Desakorn Varunee, Wilairatana Polrat, Krudsood Srivicha, Pitisuttithum Punnee
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2005 Mar;36(2):362-9.
A descriptive, combined retrospective and prospective study was conducted at the Anonymous Clinic, Chon Buri Hospital, Chon Buri Province, Thailand from November 10, 2003 to January 4, 2004. A total of 83 adult HIV-treatment-naïve patients undergoing treatment with GPO-VIR (stavudine, lamivudine, and nevirapine) for at least one year were studied. The objectives of the study were to assess the efficacy of GPO-VIR by evaluating body weight changes, CD4 T-cell count changes, the occurrence of opportunistic infections, and long-term side effects, such as lipodystrophy, during treatment. Of 83 studied patients, approximately half (52.3%) of them had a body weight increase > 10% of pre-treatment body weight after 12 months treatment. After taking GPO-VIR, CD4 T-cell counts increased rapidly, by a median of 78 x 10(6) cells/l during the first three months. 39.5% of the patients attained median CD4 counts > 200 x 10(6) cells/I, and 11.6% achieved > 500 x 10(6) cells/l after 2 years of treatment. The occurrence of opportunistic infections was significantly lower after treatment with GPO-VIR (p = 0.001). Subjective assessment of lipodystrophy by physicians and patients showed that 16.8% had symptoms of lipodystrophy within 2 years of GPO-VIR treatment. There was a significant association between older age group (40-49 years) and occurrence of lipodystrophy (p = 0.043). GPO-VIR is an inexpensive and effective antiretroviral drug regimen for initiating treatment of naïve patients, but careful assessment for lipodystrophy is necessary, especially after one year of treatment.
2003年11月10日至2004年1月4日，在泰国春武里府春武里医院的匿名诊所进行了一项描述性、回顾性与前瞻性相结合的研究。共研究了83例初治成人HIV患者，这些患者接受GPO-VIR（司他夫定、拉米夫定和奈韦拉平）治疗至少一年。该研究的目的是通过评估体重变化、CD4 T细胞计数变化、机会性感染的发生情况以及治疗期间的长期副作用（如脂肪代谢障碍）来评估GPO-VIR的疗效。在83例研究患者中，约一半（52.3%）在治疗12个月后体重增加超过治疗前体重的10%。服用GPO-VIR后，CD4 T细胞计数迅速增加，在前三个月中值增加了78×10⁶个细胞/升。39.5%的患者在治疗2年后CD4计数中值>200×10⁶个细胞/升，11.6%的患者达到>500×10⁶个细胞/升。接受GPO-VIR治疗后，机会性感染的发生率显著降低（p = 0.001）。医生和患者对脂肪代谢障碍的主观评估显示，在接受GPO-VIR治疗的2年内，16.8%的患者有脂肪代谢障碍症状。年龄较大的组（40 - 49岁）与脂肪代谢障碍的发生之间存在显著关联（p = 0.043）。GPO-VIR是一种用于初治患者开始治疗的廉价且有效的抗逆转录病毒药物方案，但需要仔细评估脂肪代谢障碍，尤其是在治疗一年后。
