AIDS Research Laboratory, Department of Infectious Diseases, Second Xiangya Hospital, Central South University, Changsha, China.
Intervirology. 2010;53(4):240-6. doi: 10.1159/000302762. Epub 2010 Mar 30.
To evaluate the long-term efficacy and tolerability of nevirapine (NVP)-based regimens in the treatment of human immunodeficiency virus (HIV)-infected Chinese patients in routine clinical practice.
From October 2002 to May 2004, 57 HIV-1-infected patients commenced antiretroviral therapy (ART), and were followed up to December 2008. These antiretroviral-naïve patients, who originally received two nucleoside reverse transcriptase inhibitors and NVP, had HIV RNA levels, T lymphocyte subsets and safety parameters assessed over 6 years.
Of the 57 patients, 34 patients participated in the long-term follow-up. After 5-6 years, >60% of the patients had HIV RNA levels <50 copies/microl, and the median increase in CD4 cell counts from baseline was 329 cells/microl. gamma-Glutamyl transferase increased in 17 patients (29.8%); serum cholesterol and triglyceride levels were elevated in 15 patients (26.3%), and 25.0% (6/24) of the patients developed lipodystrophy (mainly females). Grade 3/4 adverse events occurred in 3 cases.
ART with NVP-based regimens suppressed HIV viremia and produced continued CD4 cell increases in a majority of subjects for 6 years. Safety and tolerance were good with no unexpected long-term toxicity. Though based on a small group, this study demonstrates durable effects of ART in Chinese patients.
评估在常规临床实践中,基于奈韦拉平(NVP)的方案治疗中国 HIV 感染者的长期疗效和耐受性。
2002 年 10 月至 2004 年 5 月,57 例 HIV-1 感染患者开始接受抗逆转录病毒治疗(ART),并随访至 2008 年 12 月。这些最初接受两种核苷逆转录酶抑制剂和 NVP 的抗逆转录病毒初治患者,在 6 年内评估了 HIV RNA 水平、T 淋巴细胞亚群和安全性参数。
57 例患者中,34 例患者参与了长期随访。经过 5-6 年,>60%的患者 HIV RNA 水平<50 拷贝/微升,从基线开始 CD4 细胞计数中位数增加了 329 个/微升。17 例(29.8%)患者γ-谷氨酰转移酶升高;15 例(26.3%)患者血清胆固醇和甘油三酯水平升高,25.0%(6/24)的患者发生脂肪营养不良(主要为女性)。发生 3 例 3/4 级不良事件。
基于 NVP 的方案的 ART 抑制了 HIV 病毒血症,并使大多数患者在 6 年内持续增加 CD4 细胞。安全性和耐受性良好,无意外的长期毒性。尽管该研究基于一个小群体,但它表明了 ART 在我国患者中的持久疗效。