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多替拉韦为基础的治疗方案在 HIV 艾滋病初治患者中显示出了 CD4 细胞计数恢复和病毒载量抑制的效果:一项初步评估。

Dolutegravir based therapy showed CD4 T cell count recovery and viral load suppression among ART naïve people living with HIV AIDS: a pilot evaluation.

机构信息

University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Department of Hematology and Immunohematology, University of Gondar, Gondar, Ethiopia.

出版信息

Sci Rep. 2024 Feb 8;14(1):3297. doi: 10.1038/s41598-024-53282-y.

Abstract

Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4 T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4 T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4 T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5-732994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4 T-cell count increased significantly during treatment: median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4 T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes.

摘要

最近,自 2018 年 7 月以来,世界卫生组织(WHO)推荐将基于多替拉韦(DTG)的联合疗法作为更有效和更安全的一线抗逆转录病毒疗法(ART),用于治疗人类免疫缺陷病毒(HIV)。然而,在 HIV 流行的埃塞俄比亚,尚未研究 DTG 为基础的治疗对 CD4 T 细胞计数和病毒载量抑制的效果。因此,我们旨在对埃塞俄比亚的 HIV 感染者(PLWH)进行基于 DTG 的治疗对 CD4 T 细胞计数和病毒载量计数的影响进行初步评估。这是一项从 2020 年 7 月至 2021 年 2 月进行的纵向前瞻性队列研究。共招募了 109 名计划开始 DTG 为基础治疗的抗逆转录病毒药物初治的 PLWH。采用聚合酶链反应检测 HIV 病毒核糖核酸(RNA)拷贝数。为了计算基线、第 3 个月和第 6 个月病毒载量和 CD4 T 细胞计数的差异,采用 Friedman 检验。该研究包括 109 名从未接受过抗逆转录病毒药物治疗的 PLWH。接受 DTG 为基础治疗的患者的病毒载量(拷贝/mL)中位数(IQR)值从基线时的 446812(237649.5-732994.5)显著下降至 3 个月时的 34(23.5-46)和 6 个月时的 0.0(0-19)。尽管治疗使 HIV-1 RNA 50 拷贝/mL 的参与者比例从基线时的 0(0%)分别增加到第 3 个月和第 6 个月的 87(79.8%)和 100(91.7%),但另一方面,CD4 T 细胞计数在治疗期间显著增加:中位数(IQR):209(81.5-417.5)与 291(132-522)与 378(181-632.5)细胞/L 在基线、治疗随访的第 3 个月和第 6 个月。我们发现基于多替拉韦的治疗是一种有前途的选择,具有高病毒学抑制率和 CD4 T 细胞计数恢复,表明细胞免疫得到恢复。此外,治疗开始后病毒载量抑制率很高。我们建议进行更多参与者的进一步研究,以提高对治疗结果的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f8/10853173/d1806c210fc9/41598_2024_53282_Fig1_HTML.jpg

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