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接受利托那韦增效达芦那韦/多替拉韦双药治疗的 HIV 感染者的健康相关生活质量:DUALIS 子研究。

Health-related quality-of-life in people living with HIV after switching to dual therapy with ritonavir-boosted darunavir + dolutegravir: a DUALIS sub-study.

机构信息

Department of Psychosomatic Medicine and Psychotherapy, Klinik Barmelweid AG, Barmelweid, Switzerland.

Psymeta GmbH, Clinical Research Organisation, Schafisheim, Switzerland.

出版信息

AIDS Care. 2022 Jun;34(6):698-707. doi: 10.1080/09540121.2021.1916873. Epub 2021 Apr 25.

Abstract

The DUALIS study demonstrated efficacy and safety of switching to dolutegravir plus ritonavir-boosted darunavir (DRV/r) (2DR) as compared to standard-of-care-therapy with two nucleoside reverse transcriptase inhibitors + DRV/r (3DR) in pretreated people living with HIV (PLWH), 48 weeks after switching. This DUALIS sub-study investigates health-related-quality-of-life (HrQoL) in this study-population. The Hospital Anxiety and Depression Scale (HADS) and the Medical Outcome Survey-HIV (MOS-HIV) were used assessing anxiety and depression symptoms, respectively HrQoL. Data were collected at baseline, 4, 24, and 48 weeks after randomization. Outcome scores were dichotomized and used as criteria in longitudinal models identifying differential developments. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed as main measures of effects. ORs<1 indicate better results for HADS, and worse for MOS-HIV scores in the 2DR compared to 3DR group. In total, 263 subjects were randomized and treated (2DR n=131, 3DR n=132; median age 48 years). Significant different progressions could only be found for HADS-Depression scores (OR=.87, 95% CI: .78, .98, =.02). While HADS-Depression scores decreased in the 2DR group, they increased in 3DR group. This sub-study showed no disadvantages regarding HrQoL in PLWH after switching to DTG+DRV/r. Considering lifelong requirements for antiretroviral medication, close attention to HrQL is required.

摘要

DUALIS 研究表明,与标准护理疗法(即两种核苷逆转录酶抑制剂+DRV/r[3DR])相比,在预先治疗的 HIV 感染者(PLWH)转换后 48 周,转换为多替拉韦加拉米夫定(DTG)+利托那韦增强的达芦那韦(DRV/r)(2DR)具有疗效和安全性。这项 DUALIS 子研究调查了该研究人群的健康相关生活质量(HrQoL)。采用医院焦虑和抑郁量表(HADS)和医疗结局研究 HIV 量表(MOS-HIV)分别评估焦虑和抑郁症状以及 HrQoL。数据在基线、随机分组后 4、24 和 48 周收集。将结局评分分为二项,并在纵向模型中用作识别不同发展的标准。比值比(OR)及其 95%置信区间(CI)被计算为主要的效应测量指标。OR<1 表示 2DR 组的 HADS 评分和 MOS-HIV 评分较 3DR 组更好。共有 263 名受试者被随机分组并接受治疗(2DR n=131,3DR n=132;中位年龄 48 岁)。仅发现 HADS 抑郁评分存在显著不同的进展(OR=0.87,95%CI:0.78,0.98,P=0.02)。虽然 2DR 组的 HADS 抑郁评分降低,但 3DR 组的评分增加。这项子研究表明,PLWH 转换为 DTG+DRV/r 后,在 HrQoL 方面没有劣势。考虑到抗逆转录病毒药物的终身需求,需要密切关注 HrQL。

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