Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
Department of Infectious Disease, Lanzhou Pulmonary Hospital, Lanzhou, 730046, China.
BMC Infect Dis. 2020 Feb 19;20(1):158. doi: 10.1186/s12879-020-4878-2.
Although the global human immunodeficiency virus (HIV) epidemic has improved significantly due to antiretroviral treatment (ART), ART-related adverse events (AEs) remain an issue. Therefore, investigating the factors associated with ART-related AEs may provide vital information for monitoring risks.
A prospective cohort study was conducted among adult patients (aged 18 years or older) with HIV who received Tenofovir (TDF) + Lamivudine (3TC) + Efavirenz (EFV) as first-line ART regimens. All AEs during the first 12 months of therapy were recorded. Logistic regression analysis was used to identify variables associated with AEs.
Four hundred seventy-four patients receiving TDF+ 3TC+ EFV ART regimens between March 2017 and October 2017 were included in the study analysis. Among them, 472 (99.6%) experienced at least one AE, 436 (92.0%) patients experienced at least one AE within 1 month of treatment, 33 (7.0%) between one and 3 months of treatment, and three (0.6%) patients after 3 months of treatment. The most commonly reported AE was nervous system (95.6%) related, followed by dyslipidemia (79.3%), and impaired liver function (48.1%). Patients with baseline body mass index (BMI) greater than 24 kg/m (adjusted OR 1.77, 95%CI 1.03-3.02), pre-existing multiple AEs (adjusted OR 2.72, 95%CI 1.59-4.64), and pre-existing severe AEs (adjusted OR 5.58, 95%CI 2.65-11.73) were at increased odds of developing a severe AE. Patients with baseline BMI greater than 24 kg/m (adjusted OR 2.72, 95%CI 1.25-5.89) were more likely to develop multiple AEs.
The incidence of ART-related adverse events over a 12-month period in China was high. Baseline BMI greater than 24 kg/m, pre-existing multiple AEs, and pre-existing severe AEs were shown to be independent risk factors for developing a severe AE.
尽管由于抗逆转录病毒治疗(ART),全球人类免疫缺陷病毒(HIV)流行情况已有显著改善,但与 ART 相关的不良事件(AE)仍然是一个问题。因此,研究与 ART 相关 AE 相关的因素可为监测风险提供重要信息。
对接受替诺福韦(TDF)+拉米夫定(3TC)+依非韦伦(EFV)作为一线 ART 方案的成年 HIV 患者(年龄 18 岁或以上)进行前瞻性队列研究。记录治疗的前 12 个月期间所有 AE。使用逻辑回归分析来确定与 AE 相关的变量。
在 2017 年 3 月至 2017 年 10 月期间,纳入了 474 例接受 TDF+3TC+EFV ART 方案的患者。其中,472 例(99.6%)至少经历了一次 AE,436 例(92.0%)在治疗后 1 个月内至少经历了一次 AE,33 例(7.0%)在 1-3 个月之间,3 例(0.6%)在 3 个月后。最常见的报告 AE 与神经系统(95.6%)有关,其次是血脂异常(79.3%)和肝功能受损(48.1%)。基线体重指数(BMI)大于 24kg/m2(调整后的比值比 1.77,95%CI 1.03-3.02)、基线时存在多种 AE(调整后的比值比 2.72,95%CI 1.59-4.64)和基线时存在严重 AE(调整后的比值比 5.58,95%CI 2.65-11.73)的患者发生严重 AE 的可能性增加。基线 BMI 大于 24kg/m2(调整后的比值比 2.72,95%CI 1.25-5.89)的患者更可能发生多种 AE。
在中国,12 个月期间 ART 相关不良事件的发生率较高。基线 BMI 大于 24kg/m2、基线时存在多种 AE 和基线时存在严重 AE 是发生严重 AE 的独立危险因素。