在临床实践中，替拉那韦/利托那韦（TPV/r）与达芦那韦/利托那韦（DRV/r）方案的病毒学和免疫学有效性。

Virologic and immunologic effectiveness of tipranavir/ritonavir (TPV/r)- versus darunavir/ritonavir (DRV/r)-based regimens in clinical practice.

作者信息

Antoniou Tony, Raboud J M, Diong C, Su D, Dewhurst N, Buckley V, Kovacs C, Rachlis A, Brunetta J, Smith G, Gough K, Fletcher D, Loutfy M R

机构信息

University of Toronto, Toronto, Ontario, Canada, Maple Leaf Medical Clinical, Toronto, Ontario, Canada.

出版信息

J Int Assoc Physicians AIDS Care (Chic). 2010 Nov-Dec;9(6):382-9. doi: 10.1177/1545109710382041.

DOI:10.1177/1545109710382041

PMID:21138833

Abstract

BACKGROUND

Although both tipranavir and darunavir are important options for the management of patients with multidrug resistant HIV, there are at present no studies comparing the effectiveness and safety of these 2 antiretroviral drugs in this population of patients.

OBJECTIVE

To compare the effectiveness and safety of ritonavir (TPV/r)- and darunavir/ritonavir (DRV/ r)-based therapies in treatment-experienced patients (n = 38 and 47, respectively).

METHODS

Multicenter, retrospective cohort study.

RESULTS

The median baseline viral load and CD4 count were 4.7 copies/mL (interquartile range [IQR] 4.3, 5.2) and 168 cells/mm( 3) (IQR 80, 252) for TPV/r patients and 4.7 copies/mL (IQR 3.7, 5.1) and 171 cells/mm(3) (IQR 92, 290) for DRV/r patients. The median number of years on antiretroviral therapy (ART) prior to starting DRV/r or TPV/r were 12.7 (10.2-15.5) and 10.5 (8.4-12.6), respectively (P < .01). Current raltegravir (RAL) use (odds ratio [OR] 5.53, 95% CI 1.08-28.34) was significantly associated with virologic suppression at week 24 in multivariable logistic regression models, whereas the use of TPV/r was not significantly associated with virologic suppression compared to DRV/r (OR 0.93, 95% CI 0.27-3.18, P = .91).

CONCLUSION

No significant difference was observed between DRV/r and TPV/r in terms of virologic suppression.

摘要

背景

虽然替拉那韦和达芦那韦都是治疗多重耐药HIV患者的重要选择，但目前尚无研究比较这两种抗逆转录病毒药物在该患者群体中的有效性和安全性。

目的

比较基于利托那韦（TPV/r）和达芦那韦/利托那韦（DRV/r）的疗法在有治疗经验患者（分别为38例和47例）中的有效性和安全性。

方法

多中心回顾性队列研究。

结果

TPV/r组患者的基线病毒载量中位数和CD4细胞计数分别为4.7拷贝/毫升（四分位间距[IQR]4.3，5.2）和168个细胞/立方毫米（IQR 80，252），DRV/r组患者分别为4.7拷贝/毫升（IQR 3.7，5.1）和171个细胞/立方毫米（IQR 92，290）。开始DRV/r或TPV/r治疗前接受抗逆转录病毒治疗（ART）的年限中位数分别为12.7（10.2 - 15.5）年和10.5（8.4 - 12.6）年（P < 0.01）。在多变量逻辑回归模型中，当前使用雷特格韦（RAL）（比值比[OR]5.53，95%可信区间1.08 - 28.34）与第24周时病毒学抑制显著相关，而与DRV/r相比，TPV/r的使用与病毒学抑制无显著相关性（OR 0.93，95%可信区间0.27 - 3.18，P = 0.91）。