Kefale Adane Teshome, Dadi Tegene Legese, Biru Tessema Tsehay, Mega Teshale Ayele
College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia.
Institute of Health Sciences, Jimma University, Jimma, Ethiopia.
Open AIDS J. 2018 May 31;12:38-52. doi: 10.2174/1874613601812010038. eCollection 2018.
Findings from different studies report inferior clinical and virologic efficacy with TDF/3TC/NVP. But, some studies show that, there was no statistically significant difference in mortality among ZDV and TDF based regimens. The objective of this review was to systematically identify, appraise and synthesize the best available evidence on efficacy and safety of TDF based regimen as compared to ZDV based regimens.
A three-step search strategy was used to locate published and unpublished studies. First, an initial limited search of google was undertaken followed by analysis of text words. A second extensive search was undertaken. We searched the PubMed, EMBASE, Google Scholar, Medline, and CINHAL. We did the initial search for articles on July 11-18, 2016, and updated the results on May 13, 2017.Third, the reference lists of all identified articles was searched for additional studies.
ZDV based regimens had better outcome on prevention of mortality (OR=1.31, 95%CI (1.14, 1.50), I = 0%, Chi = 2.51), and lower virologic failure (OR = 1.44, 95% CI [1.18, 1.76], chi = 5.91, P= 0.003, I =83%) while, TDF based regimens were more tolerable (OR=0.15, 95%CI (0.08, 0.30), I = 40%, Chi = 3.31). The difference in incidence of opportunistic infection is not significant (OR = 0.83, 95% CI [0.52, 1.32], chi = 0.11, P= 0.42, I =0%).
There is lower mortality and lower virologic failure in ZDV group, but better safety profile among TDF based regimens.
不同研究的结果显示，替诺福韦酯（TDF）/拉米夫定（3TC）/奈韦拉平（NVP）的临床和病毒学疗效较差。但是，一些研究表明，基于齐多夫定（ZDV）和基于TDF的治疗方案在死亡率方面没有统计学上的显著差异。本综述的目的是系统地识别、评估和综合与基于ZDV的治疗方案相比，基于TDF的治疗方案在疗效和安全性方面的最佳现有证据。
采用三步搜索策略来查找已发表和未发表的研究。首先，对谷歌进行初步的有限搜索，然后分析文本词汇。进行第二次广泛搜索。我们搜索了PubMed、EMBASE、谷歌学术、Medline和CINHAL。我们于2016年7月11日至18日对文章进行了初步搜索，并于2017年5月13日更新了结果。第三，搜索所有已识别文章的参考文献列表以查找其他研究。
基于ZDV的治疗方案在预防死亡率方面有更好的结果（OR=1.31，95%CI（1.14，1.50），I=0%，Chi=2.51），病毒学失败率更低（OR=1.44，95%CI[1.18，1.76]，chi=5.91，P=0.003，I=83%），而基于TDF的治疗方案更具耐受性（OR=0.15，95%CI（0.08，0.30），I=40%，Chi=3.31）。机会性感染发生率的差异不显著（OR=0.83，95%CI[0.52，1.32]，chi=0.11，P=0.42，I=0%）。
ZDV组的死亡率和病毒学失败率较低，但基于TDF的治疗方案安全性更好。
