Greenberg Keiko I, Perazella Mark A, Atta Mohamed G
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.
Semin Dial. 2015 Jul-Aug;28(4):397-403. doi: 10.1111/sdi.12367. Epub 2015 Apr 6.
Human immunodeficiency virus (HIV) infection and hepatitis C virus (HCV) infection affect populations worldwide. With the availability of over 35 Food and Drug Administration approved medications for treatment of HIV, the morbidity and mortality associated with HIV has greatly improved. On the other hand, treatment options for HCV have been limited until very recently. While the use of protease inhibitors (such as boceprevir and telaprevir) has become standard of care for treatment of hepatitis C in the general population, data for individuals with impaired kidney function, particularly those on dialysis, are extremely limited. Use of medications in dialysis patients can be challenging given the dose adjustments that must be made for renally cleared molecules, and potentially increased impact of adverse effects such as anemia. Recommendations for dosing of marketed therapies for HIV and HCV are reviewed.
人类免疫缺陷病毒(HIV)感染和丙型肝炎病毒(HCV)感染影响着全球人口。随着美国食品药品监督管理局(FDA)批准了35种以上用于治疗HIV的药物,与HIV相关的发病率和死亡率已大大改善。另一方面,直到最近,HCV的治疗选择一直有限。虽然蛋白酶抑制剂(如博赛匹韦和特拉匹韦)的使用已成为普通人群丙型肝炎治疗的标准疗法,但肾功能受损患者,尤其是透析患者的数据极为有限。鉴于必须对经肾脏清除的分子进行剂量调整,以及诸如贫血等不良反应可能增加的影响,在透析患者中使用药物可能具有挑战性。本文综述了已上市的HIV和HCV治疗药物的给药建议。