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转换为单片固定剂量方案后,围产期感染HIV-1的青少年患者报告的结局和低水平残留HIV-RNA

Patient-reported outcomes and low-level residual HIV-RNA in adolescents perinatally infected with HIV-1 after switching to one-pill fixed-dose regimen.

作者信息

Rosso Raffaella, Di Biagio Antonio, Maggiolo Franco, Nulvesu Loredana, Callegaro Anna Paola, Taramasso Lucia, Bruzzone Bianca, Viscoli Claudio

机构信息

Clinica Malattie Infettive, Ospedale San Martino, Università degli Studi di Genova, Genova, Italy.

出版信息

AIDS Care. 2012;24(1):54-8. doi: 10.1080/09540121.2011.596511. Epub 2011 Jul 29.

DOI:10.1080/09540121.2011.596511
PMID:21800951
Abstract

The choice of an antiretroviral regimen can often impact on adherence, treatment satisfaction and therefore influence on clinical outcome. These concerns are particularly true in adolescents. In this setting, adherence is usually affected by multifactor events and biopsychosocial factors, which connect and changeover time. We evaluated the effect of a switch to a single-pill fixed-dose regimen on patient-reported outcomes, virologic and immunologic outcomes, and safety in a cohort of adolescents with perinatal HIV-1 infection. In addition, we evaluated the effect on low-level residual HIV-RNA. An open-label, non-randomised study was performed: 12 adolescents with a confirmed viremia <50 copies/mL treated with lamivudine or emtricitabine, tenofovir and efavirenz were switched to one-pill fixed-dose regimen of emtricitabine/tenofovir/efavirenz. At the end of follow-up, the new regimen was associated with improvements in treatment satisfaction, HIV-symptoms, whereas adherence remained high. No immunological or virological significative changes were observed. No side-effects were registered. Moreover, the low-level residual HIV-RNA was <3 copie/mL in all patients. One-pill fixed-dose regimen is an added value that favours adherence, reduces HIV-symptoms, improves patients' satisfaction and could better control of HIV-RNA in adolescents, too.

摘要

抗逆转录病毒治疗方案的选择通常会影响服药依从性、治疗满意度,进而影响临床结局。这些问题在青少年中尤为突出。在这种情况下,依从性通常受到多因素事件和生物心理社会因素的影响,这些因素相互关联并随时间变化。我们评估了转换为单片固定剂量方案对一组围产期感染HIV-1的青少年患者报告结局、病毒学和免疫学结局以及安全性的影响。此外,我们还评估了其对低水平残留HIV-RNA的影响。我们开展了一项开放标签、非随机研究:12名确诊病毒血症<50拷贝/mL且正在接受拉米夫定或恩曲他滨、替诺福韦和依非韦伦治疗的青少年,转换为恩曲他滨/替诺福韦/依非韦伦单片固定剂量方案。随访结束时,新方案与治疗满意度、HIV症状改善相关,且依从性保持较高水平。未观察到免疫学或病毒学方面的显著变化。未记录到副作用。此外,所有患者的低水平残留HIV-RNA均<3拷贝/mL。单片固定剂量方案是一项附加优势,有利于提高依从性、减轻HIV症状、改善患者满意度,并且在青少年中也能更好地控制HIV-RNA。

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