Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark;
Clin Epidemiol. 2010 Aug 9;2:145-51. doi: 10.2147/clep.s10478.
Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.
From a Danish population-based nationwide cohort of HIV patients we identified the individuals who initiated a salvage regimen including raltegravir and a matched cohort of HIV-infected patients initiating HAART for the first time. We compared these two cohorts for virological suppression, gain in CD4 count, and time to first change of initial regimen.
We identified 32 raltegravir patients and 64 HIV patients who initiated HAART for the first time in the period 1 January 2006 to 1 July 2009. The virological and immunological responses in the raltegravir patients were comparable to those seen in the control cohort. No patients in the two cohorts died and no patients terminated raltegravir treatment in the observation period. Time to first change of initial regimen was considerably shorter for HAART-naïve patients.
We conclude that salvage regimens including raltegravir have high effectiveness in the everyday clinical setting. The effectiveness of the regimens is comparable to that observed for patients initiating HAART for the first time. The risk of change in the salvage regimens after initiation of raltegravir is low.
拉替拉韦是第一种获准用于治疗携带多种耐药病毒的 HIV 感染患者的整合酶抑制剂。
我们从丹麦一个基于人群的全国性 HIV 患者队列中确定了开始包含拉替拉韦的挽救治疗方案的个体，并与首次开始高效抗逆转录病毒治疗（HAART）的 HIV 感染患者进行了匹配队列比较。我们比较了这两组患者的病毒学抑制、CD4 计数增加以及首次改变初始方案的时间。
我们确定了 32 名拉替拉韦患者和 64 名在 2006 年 1 月 1 日至 2009 年 7 月 1 日期间首次开始 HAART 的 HIV 患者。拉替拉韦组的病毒学和免疫学反应与对照组相似。两组均无患者死亡，且在观察期内均无患者终止拉替拉韦治疗。首次改变初始方案的时间在 HAART 初治患者中明显缩短。
我们的结论是，包含拉替拉韦的挽救治疗方案在日常临床实践中具有很高的疗效。这些方案的疗效与首次开始 HAART 的患者观察到的疗效相当。拉替拉韦治疗开始后改变挽救方案的风险较低。
