Jabłonowska Elżbieta, Pulik Piotr, Kalinowska Anna, Gąsiorowski Jacek, Parczewski Miłosz, Bociąga-Jasik Monika, Mularska Elżbieta, Pulik Łukasz, Siwak Ewa, Wójcik Kamila
Clinic of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland.
Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland.
Arch Med Sci. 2018 Jun;14(4):860-864. doi: 10.5114/aoms.2016.62445. Epub 2016 Sep 22.
The aim of the study was to present the experience of Polish centers regarding dual therapy based on the integrase inhibitor raltegravir (RAL) and ritonavir-boosted protease inhibitors (PI/r) for treating treatment-naïve and -experienced HIV-infected patients.
The paper concerns a retrospective multicenter study. The medical databases of six main Polish HIV centers from January 2009 to December 2014 were analyzed for the use of combined antiretroviral treatment consisting of RAL + PI/r. This study included 126 HIV-infected patients receiving RAL + PI/r therapy, of whom 17 patients were treatment-naive and 109 patients were treatment-experienced.
In treatment-experienced patients, the most common reasons for the introduction of a RAL + PI/r regimen were virologic failure and impaired renal function (45 of 109 patients). In the treatment-naïve group kidney disease was the cause of the RAL + PI/r regimen in 3 of 17 participants. In treatment-experienced patients, 80% of individuals still were on RAL + PI/r treatment after 12 months, 65% after 24 months and 53% of subjects after 60 months. In both groups, the simplification of the antiretroviral regimen was the most common reason for discontinuation of RAL + PI/r based therapy.
In antiretroviral-experienced patients the dual therapy based on RAL + PI/s is safe and effective. In antiretroviral-naïve patients the RAL + PI/r regimen is rarely used in Poland.
本研究的目的是介绍波兰各中心在使用整合酶抑制剂拉替拉韦（RAL）和利托那韦增强型蛋白酶抑制剂（PI/r）进行双重治疗，以治疗初治和经治HIV感染患者方面的经验。
本文涉及一项回顾性多中心研究。分析了2009年1月至2014年12月波兰六个主要HIV中心的医学数据库中RAL + PI/r联合抗逆转录病毒治疗的使用情况。本研究纳入了126例接受RAL + PI/r治疗的HIV感染患者，其中17例为初治患者，109例为经治患者。
在经治患者中，开始使用RAL + PI/r方案的最常见原因是病毒学失败和肾功能受损（109例患者中的45例）。在初治组中，17名参与者中有3名因肾病而采用RAL + PI/r方案。在经治患者中，80%的个体在12个月后仍在接受RAL + PI/r治疗，24个月后为65%，60个月后为53%。在两组中，简化抗逆转录病毒方案是停用基于RAL + PI/r治疗的最常见原因。
在有抗逆转录病毒治疗经验的患者中，基于RAL + PI/s的双重治疗是安全有效的。在波兰，初治HIV患者很少使用RAL + PI/r方案。
