Sun J, Chen J, Yao Y, Zhang R, Zheng Y, Liu L, Zhang L, Shen Y, Lu H
Department of Infectious Diseases, Shanghai Public Health Clinical Center affiliated to Fudan University, Shanghai, China.
Int J STD AIDS. 2010 Dec;21(12):810-3. doi: 10.1258/ijsa.2010.010114.
To assess the relationship between mean efavirenz (EFV) plasma concentration and clinical effect during the first 48 weeks of combination antiretroviral therapy (cART), the baseline CD4 cell count was recorded and plasma EFV concentration and CD4 cell count were measured every 12 weeks. HIV-RNA viral load was determined in the 48th week of cART. In total, 42 subjects were recruited and grouped according to their mean concentration of EFV during the study period: groups A, B and C with EFV concentrations (mean) <2 mg/L (1.8 mg/L), 2-4 mg/L (2.9 mg/L) and >4 mg/L (5.5 mg/L), respectively. The CD4 cell counts in group C increased more quickly than in groups B and A, although this was not statistically significant (211 ± 176/μL versus 151 ± 145/μL and 172 ± 105/μL, respectively; P = 0.799). Groups B and C had higher rates of HIV viral load suppression than group A (P = 0.017). For treatment-naïve Chinese HIV-infected patients, EFV plasma concentrations above 2 mg/L appear to suppress HIV replication more effectively than concentrations below 2 mg/L.
为评估在联合抗逆转录病毒治疗（cART）的前48周期间，依非韦伦（EFV）血浆平均浓度与临床疗效之间的关系，记录了基线CD4细胞计数，并每12周测量一次血浆EFV浓度和CD4细胞计数。在cART的第48周测定HIV-RNA病毒载量。总共招募了42名受试者，并根据他们在研究期间的EFV平均浓度进行分组：A组、B组和C组的EFV浓度（均值）分别<2 mg/L（1.8 mg/L）、2 - 4 mg/L（2.9 mg/L）和>4 mg/L（5.5 mg/L）。C组的CD4细胞计数比B组和A组增加得更快，尽管这在统计学上不显著（分别为211±176/μL、151±145/μL和172±105/μL；P = 0.799）。B组和C组的HIV病毒载量抑制率高于A组（P = 0.017）。对于未接受过治疗的中国HIV感染患者，EFV血浆浓度高于2 mg/L似乎比低于2 mg/L更有效地抑制HIV复制。
