Mata-Marín José Antonio, Smeke Ariane Estrella Weiser, Rodriguez Mariana Rotzinger, Chávez-García Marcelino, Banda-Lara Marco Isaac, Rios Alma Minerva Pérez, Nuñez-Rodríguez Nohemí, Domínguez-Hermosillo Juan Carlos, Sánchez Alberto Chaparro, Juarez-Kasusky Irene, Herrera Javier Enrique Cruz, Ramírez Jorge Luis Sandoval, Gaytán-Martínez Jesús
Infectious Diseases Department, Hospital de Infectología, National Medical Center "La Raza", IMSS, Mexico City, Mexico.
Medicine School, Universidad Anáhuac, Campus norte, Av. Universidad Anáhuac 46, Lomas Anahuac, 52786, Naucalpan de Juárez, Mexico City, Mexico.
Drugs R D. 2017 Mar;17(1):225-231. doi: 10.1007/s40268-017-0174-z.
We evaluated the effectiveness of a raltegravir (RAL)-containing regimen plus an optimized background regimen in HIV-1 highly treatment-experienced patients.
A retrospective cohort, multicentre study was conducted.
Adult (>16 years old) HIV treatment-experience patients starting therapy with a RAL-containing regimen were included. Effectiveness was evaluated as the percentage of patients with an undetectable HIV-1 RNA viral load (<50 and <200 copies/mL) after 48 weeks, and changes in CD4+ cell counts. We evaluated the risk factors associated with treatment failure.
Of the 107 patients in the cohort, 86% were men, the median age was 45 years [interquartile range (IQR) 40-52] and the median number of previous regimens was six (IQR 4-7). After 48 weeks of treatment, 73% (IQR 63-80%) of patients (n = 78) had a viral load of <50 copies/mL and 85% (IQR 77-90%) (n = 91) had <200 copies/mL. In a logistic regression model, risk factors associated with a virological outcome of HIV-1 RNA of <200 copies/mL were age >40 years [odds ratio (OR) 5.61; 95% confidence interval (CI) 1.61-18.84; P = 0.006] and use of tenofovir in the regimen (OR 0.16; 95% CI 0.03-0.80; P = 0.026).
In this Mexican cohort, RAL achieved high rates of virological suppression and an increase in CD4+ cell count in highly treatment-experienced patients infected with HIV-1. Age >40 years was associated with a good virological outcome, contrary to tenofovir use, which was associated with a poor virological outcome.
我们评估了含拉替拉韦（RAL）方案联合优化背景方案在HIV-1高度经治患者中的有效性。
进行了一项回顾性队列多中心研究。
纳入开始接受含RAL方案治疗的成年（>16岁）HIV经治患者。有效性评估为48周后HIV-1 RNA病毒载量不可检测（<50和<200拷贝/毫升）的患者百分比以及CD4+细胞计数的变化。我们评估了与治疗失败相关的危险因素。
队列中的107例患者中，86%为男性，中位年龄为45岁[四分位间距（IQR）40 - 52]，既往方案的中位数量为6种（IQR 4 - 7）。治疗48周后，73%（IQR 63 - 80%）的患者（n = 78）病毒载量<50拷贝/毫升，85%（IQR 77 - 90%）（n = 91）<200拷贝/毫升。在逻辑回归模型中，与HIV-1 RNA病毒学结果<200拷贝/毫升相关的危险因素为年龄>40岁[比值比（OR）5.61；95%置信区间（CI）1.61 - 18.84；P = 0.006]以及方案中使用替诺福韦（OR 0.16；95% CI 0.03 - 0.80；P = 0.026）。
在这个墨西哥队列中，RAL在HIV-1感染的高度经治患者中实现了高病毒学抑制率并使CD4+细胞计数增加。年龄>40岁与良好的病毒学结果相关，与使用替诺福韦相反，后者与不良病毒学结果相关。
