University of South Florida College of Medicine, Division of Infectious Diseases and International Medicine, Tampa, FL, USA.
Expert Opin Drug Metab Toxicol. 2009 Dec;5(12):1599-606. doi: 10.1517/17425250903439720.
Fixed dose antiretroviral combinations (FDC) may improve therapy adherence with reduced pill burden. Abacavir and lamivudine are well-established nucleoside reverse-transcriptase inhibitors available as a once-daily FDC. Abacavir is currently considered an alternative treatment option in most established treatment guidelines based on associations with cardiovascular events and lesser efficacy in patients with higher baseline viremia.
To summarize rigorous clinical trial data and cohort studies that examine efficacy, safety and tolerability of the individual components and the FDC of abacavir-lamivudine.
Clinical trial data, post-marketing research findings and clinical cohort data were reviewed to assess the efficacy, safety and tolerability of the individual components and the FDC of abacavir-lamivudine along with recommendations from published clinical treatment guidelines.
RESULTS/CONCLUSION: The efficacy of abacavir-lamivudine is well documented in numerous clinical studies and treatment guidelines. The introduction of laboratory testing to identify patients at risk for hypersensitivity has decreased the incidence of these reactions. Recent findings suggest that abacavir is an alternative treatment agent with baseline HIV RNA > 100,000 copies/ml. Data related to cardiovascular events associated with abacavir are conflicting. Hepatic function should be monitored closely in HIV/HBV co-infected patients who discontinue lamivudine-containing products as severe acute exacerbations of HBV have been reported.
固定剂量抗逆转录病毒联合疗法（FDC）可通过减少服药次数来提高治疗依从性。阿巴卡韦和拉米夫定是两种已被广泛认可的核苷类逆转录酶抑制剂，可制成每日一次的 FDC。目前，基于与心血管事件的关联以及在基线病毒载量较高的患者中疗效较低，阿巴卡韦被大多数既定治疗指南视为替代治疗选择。
总结严格的临床试验数据和队列研究，以评估阿巴卡韦-拉米夫定的单一组分和 FDC 的疗效、安全性和耐受性。
回顾临床试验数据、上市后研究结果和临床队列数据，以评估阿巴卡韦-拉米夫定的单一组分和 FDC 的疗效、安全性和耐受性，并参考已发布的临床治疗指南中的建议。
结果/结论：大量临床研究和治疗指南都充分证明了阿巴卡韦-拉米夫定的疗效。通过实验室检测识别易发生过敏反应的患者，已降低了此类反应的发生率。最近的研究结果表明，对于基线 HIV RNA > 100,000 拷贝/ml 的患者，阿巴卡韦是一种替代治疗药物。与阿巴卡韦相关的心血管事件数据存在矛盾。对于停用含拉米夫定产品的 HIV/HBV 合并感染者，应密切监测肝功能，因为有报道称会出现乙型肝炎病毒的严重急性恶化。
