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纳曲酮治疗 HIV 相关酒精使用障碍的有效性:系统评价。

Effectiveness of naltrexone treatment for alcohol use disorders in HIV: a systematic review.

机构信息

Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Subst Abuse Treat Prev Policy. 2020 Mar 18;15(1):24. doi: 10.1186/s13011-020-00266-6.

DOI:10.1186/s13011-020-00266-6
PMID:32188486
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7081595/
Abstract

BACKGROUND

Because alcohol use disorders (AUDs) in patients living with HIV/AIDS are associated with a reduction in therapeutic outcomes and increases the risk of morbidity/mortality, finding an appropriate pharmacotherapy treatment for this disorder is necessary.

OBJECTIVES

This systematic review contains studies that examine the effects of pharmacological intervention (oral naltrexone (NTX) or injectable extended-release naltrexone (XR-NTX)) on the persons living with HIV and AUDs.

METHODS

A systematic literature search using three electronic databases including Pubmed Medline, Scopus and the Cochrane Library and Google Scholar was conducted and includes articles published from 1995 to 2019. Records were collected by searching relevant keywords and those that meet the inclusion/exclusion criteria are included.

RESULTS

Overall, in this systematic review, the results of 7 relevant studies including pilot and randomized controlled/clinical trials were summarized and reviewed. Among selected records 2 of these assessed the efficacy of NTX and 5 tested the XR-NTX effectiveness in treating AUDs among persons living with HIV (PLH). In summary, with some expectations, NTX and XR-NTX administration in persons living with HIV and AUDs led to reduced alcohol use, improved viral suppression, unchanged ART adherence and has no significant adverse events.

CONCLUSION

The findings of this systematic review suggest the beneficial effects and safety of the NTX and XR-NTX for treating AUDs in PLH. Further studies are needed in the future to focus on the treatment of AUDs in people living with HIV.

摘要

背景

由于艾滋病毒/艾滋病患者的酒精使用障碍(AUD)与治疗效果降低和发病率/死亡率增加有关,因此有必要为这种疾病寻找适当的药物治疗。

目的

本系统评价包含研究,这些研究检查了药物干预(口服纳曲酮(NTX)或注射延长释放纳曲酮(XR-NTX))对艾滋病毒感染者和 AUD 患者的影响。

方法

使用包括 Pubmed Medline、Scopus 和 Cochrane 图书馆以及 Google Scholar 在内的三个电子数据库进行了系统的文献检索,并收录了 1995 年至 2019 年发表的文章。通过搜索相关关键词收集记录,并收录符合纳入/排除标准的记录。

结果

总的来说,在本系统评价中,总结和回顾了 7 项相关研究(包括试点和随机对照/临床试验)的结果。在所选择的记录中,有 2 项评估了 NTX 的疗效,5 项测试了 XR-NTX 在治疗 HIV 感染者(PLH)AUDs 中的有效性。总的来说,NTX 和 XR-NTX 在治疗 HIV 感染者和 AUDs 方面的使用带来了一些预期的效果,包括减少饮酒、改善病毒抑制、不改变抗逆转录病毒治疗(ART)的依从性,且没有显著的不良反应。

结论

本系统评价的结果表明,NTX 和 XR-NTX 治疗 PLH 的 AUDs 具有有益效果和安全性。未来需要进一步研究,重点关注治疗 HIV 感染者的 AUDs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a5d/7081595/57efa1c58abe/13011_2020_266_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a5d/7081595/57efa1c58abe/13011_2020_266_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a5d/7081595/57efa1c58abe/13011_2020_266_Fig1_HTML.jpg

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Extended-release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living with HIV and Alcohol use Disorders Transitioning to the Community: Results From a Double-Blind, Placebo-Controlled Trial.
Medications for the Treatment of Alcohol Dependence-Current State of Knowledge and Future Perspectives from a Public Health Perspective.
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Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters.目前针对艾滋病毒感染者饮酒问题的干预措施:为何性别很重要。
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