Gebo Kelly, Voss Cindy, Mrus Joseph
School of Medicine, Johns Hopkins University, 1830 East Monument Street Suite 435, Baltimore, MD 21287, USA.
AIDS Res Treat. 2013;2013:492831. doi: 10.1155/2013/492831. Epub 2013 Jan 29.
This observational analysis examined the clinical outcomes of patients receiving etravirine-(ETR-) based therapy, particularly with protease inhibitors (PIs) other than darunavir (DRV) and with raltegravir (RAL). Data included treatment-experienced adults in the HIV Research Network who began ETR-containing antiretroviral regimens in 2008-2010. The primary objective was to assess 6-month outcomes (durability, i.e., still on an ETR-containing regimen; change in CD4+ cell count and HIV-1 RNA <400 copies/mL). The cohort included 587 patients receiving ETR; 42% of ETR use was in patients not on DRV/ritonavir (r). Patients receiving ETR plus DRV/r had longer durability versus those on ETR plus a PI other than DRV/r at months 6 (91.2% versus 85.5%) and 12 (77.4% versus 65.2%), respectively. Patients on regimens with a PI other than DRV/r were the least likely to be receiving ETR at month 6 (85.5%) versus patients on other ETR-based regimens. Patients on regimens without a PI and without RAL had lower virologic suppression (month 6, 54.2%; month 12, 63.2%) versus patients on other ETR-based regimens. In a clinical care, nontrial setting, ETR was used in regimens without DRV/r. In this population, the 6-month response rates were similar and durable across all regimens, except when ETR was used without RAL and without a PI.
这项观察性分析研究了接受基于依曲韦林(ETR)治疗的患者的临床结局,特别是与除地瑞那韦(DRV)以外的蛋白酶抑制剂(PIs)以及与拉替拉韦(RAL)联合使用时的情况。数据包括2008 - 2010年在HIV研究网络中开始含ETR抗逆转录病毒治疗方案的有治疗经验的成年人。主要目的是评估6个月的结局(持久性,即仍在接受含ETR的治疗方案;CD4 +细胞计数的变化以及HIV - 1 RNA<400拷贝/mL)。该队列包括587例接受ETR治疗的患者;42%的ETR使用情况是在未接受DRV/利托那韦(r)的患者中。接受ETR加DRV/r的患者在第6个月(91.2%对85.5%)和第12个月(77.4%对65.2%)的持久性分别长于接受ETR加除DRV/r以外的PI的患者。在第6个月时,接受除DRV/r以外的PI治疗方案的患者接受ETR治疗的可能性最小(85.5%),与接受其他基于ETR的治疗方案的患者相比。与接受其他基于ETR的治疗方案的患者相比,未使用PI且未使用RAL的治疗方案的患者病毒学抑制率较低(第6个月为54.2%;第12个月为63.2%)。在临床护理的非试验环境中,ETR用于不含DRV/r的治疗方案。在该人群中,除了未使用RAL且未使用PI而使用ETR的情况外,所有治疗方案的6个月反应率相似且持久。