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血友病合并HIV患者换用整合酶链转移抑制剂后的临床改善:日本通过血液制品感染HIV患者队列研究

Clinical Improvement by Switching to an Integrase Strand Transfer Inhibitor in Hemophiliac Patients with HIV: The Japan Cohort Study of HIV Patients Infected through Blood Products.

作者信息

Kawado Miyuki, Hashimoto Shuji, Oka Shin-Ichi, Fukutake Katsuyuki, Higasa Satoshi, Yatsuhashi Hiroshi, Ogane Miwa, Okamoto Manabu, Shirasaka Takuma

机构信息

Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan.

AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.

出版信息

Open AIDS J. 2017 Apr 26;11:18-23. doi: 10.2174/1874613601711010018. eCollection 2017.

Abstract

OBJECTIVE

This study aimed to determine improvement in HIV RNA levels and the CD4 cell count by switching to an antiretroviral regimen with an integrase strand transfer inhibitor (INSTI) in patients with HIV.

METHOD

This study was conducted on Japanese patients with HIV who were infected by blood products in the 1980s. Data were collected between 2007 and 2014. Data of 564 male hemophiliac patients with HIV from the Japan Cohort Study of HIV Patients Infected through Blood Products were available. Changes in antiretroviral regimen use, HIV RNA levels, and the CD4 cell count between 2007 and 2014 were examined.

RESULTS

From 2007 to 2014, the proportion of use of a regimen with an INSTI increased from 0.0% to 41.0%. For patients with HIV who used a regimen, including an INSTI, the proportion of HIV RNA levels <50 copies/mL significantly increased from 58.3% in 2007 to 90.6% in 2014. Additionally, the median CD4 cell count significantly increased from 380/μL to 438/μL.

CONCLUSION

There is a large effect of switching to an antiretroviral regimen with an INSTI for Japanese patients with HIV who are infected by blood products. This suggests that performing this switch in clinical practice will lead to favorable effects.

摘要

目的

本研究旨在确定在感染人类免疫缺陷病毒(HIV)的患者中,换用含整合酶链转移抑制剂(INSTI)的抗逆转录病毒治疗方案后HIV RNA水平和CD4细胞计数的改善情况。

方法

本研究针对20世纪80年代因输血感染HIV的日本患者开展。收集2007年至2014年的数据。从日本血液制品感染HIV患者队列研究中获取了564例男性血友病HIV患者的数据。研究了2007年至2014年期间抗逆转录病毒治疗方案的使用变化、HIV RNA水平和CD4细胞计数。

结果

从2007年到2014年,含INSTI方案的使用比例从0.0%增至41.0%。对于使用含INSTI方案的HIV患者,HIV RNA水平<50拷贝/毫升的比例从2007年的58.3%显著增至2014年的90.6%。此外,CD4细胞计数中位数从380/μL显著增至438/μL。

结论

对于因输血感染HIV的日本患者,换用含INSTI的抗逆转录病毒治疗方案有显著效果。这表明在临床实践中进行这种转换将产生有利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19f8/5427685/90d41d0961eb/TOAIDJ-11-18_F1.jpg

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