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中国人类免疫缺陷病毒(HIV)患者接受一线抗逆转录病毒治疗的不良反应。

Adverse events in Chinese human immunodeficiency virus (HIV) patients receiving first line antiretroviral therapy.

机构信息

Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.

Department of Infectious Disease, Lanzhou Pulmonary Hospital, Lanzhou, 730046, China.

出版信息

BMC Infect Dis. 2020 Feb 19;20(1):158. doi: 10.1186/s12879-020-4878-2.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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