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短期给予 CCR5 拮抗剂 vicriviroc 治疗 HIV 和 HCV 合并感染患者是安全耐受的。

Short-term administration of the CCR5 antagonist vicriviroc to patients with HIV and HCV coinfection is safe and tolerable.

机构信息

Department I of Internal Medicine, University of Cologne, Cologne, Germany.

出版信息

J Acquir Immune Defic Syndr. 2010 Jan;53(1):78-85. doi: 10.1097/QAI.0b013e3181bb28dc.

Abstract

OBJECTIVE

CCR5 antagonists block HIV cell entry through competitive binding to the CCR5 receptor present on the surface of CD4(+) cells. The CCR5 receptor is also present on CD8(+) cells involved in clearing hepatitis C virus (HCV). The goal of the present study was to examine the short-term safety of a CCR5 antagonist, vicriviroc, in patients with HIV/HCV coinfection.

METHODS

A randomized, double-blind trial was conducted in 28 HIV/HCV-coinfected subjects with compensated liver disease and plasma HIV RNA below 400 copies/mL. All subjects were receiving a ritonavir-enhanced protease inhibitor regimen, to which vicriviroc (5, 10, or 15 mg/day) or placebo was added for 28 days. Clinical and laboratory evaluations were performed 21 days beyond the treatment period.

RESULTS

Treatment with vicriviroc resulted in no clinically meaningful changes in HCV or HIV viral load or any immune parameters. Adverse events were equally distributed among placebo and vicriviroc groups. Transaminase elevations of grade 1 or more were reported as AEs in 1 subject receiving 10-mg vicriviroc and 1 placebo subject. Vicriviroc plasma concentrations were similar to those observed in healthy subjects.

CONCLUSIONS

Short-term treatment with vicriviroc as part of a ritonavir-containing protease inhibitor-based regimen was safe and well tolerated in HIV/HCV-coinfected subjects. HIV/HCV coinfection also did not affect vicriviroc pharmacokinetics.

摘要

目的

CCR5 拮抗剂通过与 CD4(+)细胞表面存在的 CCR5 受体竞争结合来阻止 HIV 细胞进入。CCR5 受体也存在于参与清除丙型肝炎病毒 (HCV) 的 CD8(+)细胞中。本研究的目的是研究 CCR5 拮抗剂维立西罗在 HIV/HCV 合并感染患者中的短期安全性。

方法

对 28 例代偿性肝病和血浆 HIV RNA 低于 400 拷贝/ml 的 HIV/HCV 合并感染患者进行了一项随机、双盲试验。所有患者均接受利托那韦增强型蛋白酶抑制剂治疗方案,在此基础上加用维立西罗(5、10 或 15mg/天)或安慰剂治疗 28 天。在治疗期结束后 21 天进行临床和实验室评估。

结果

维立西罗治疗并未导致 HCV 或 HIV 病毒载量或任何免疫参数发生有临床意义的变化。不良反应在安慰剂和维立西罗组之间分布均匀。1 例接受 10mg 维立西罗治疗和 1 例安慰剂治疗的患者出现 1 级或更高级别的转氨酶升高,作为 AE 报告。维立西罗的血浆浓度与在健康受试者中观察到的相似。

结论

在接受利托那韦增强型蛋白酶抑制剂治疗方案的 HIV/HCV 合并感染患者中,短期使用维立西罗作为治疗方案的一部分是安全且耐受良好的。HIV/HCV 合并感染也不会影响维立西罗的药代动力学。

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