Chen Zhong, Si Tan, Ying Li, Guiying Cao, Píng Xiè Jiàn, Wang Min
The First Hospital of Changsha, China.
Heliyon. 2024 Mar 12;10(6):e27219. doi: 10.1016/j.heliyon.2024.e27219. eCollection 2024 Mar 30.
Upon confirming an HIV diagnosis, patients need to start life-long antiretroviral therapy (ART) as soon as possible. During HIV treatment, ART drugs can cause intolerable adverse reactions, leading to poor medication compliance, treatment failure, and advancement of the HIV stage. Herein, we report a case of AIDS intolerant to multiple antiviral drugs due to side effects that we finally stabilized with the Albuvirtide (ABT) and Dolutegravir (DTG) combination. A 48 -year-old woman developed intractable nausea, vomiting and abdominal discomfort within one month of starting ART. Over the course of four years, she was switched to four different ART regimens due to her intolerance of severe adverse effects, mainly gastrointestinal symptoms, rash, and lethargy. Over four years, she failed to attain viral suppression due to poor drug compliance. After several ART changes, we started her on the Long-acting antiretroviral therapy (LA ART), Albuvirtide, combined with Dolutegravir, which she tolerated well. The patient's general condition improved significantly and attained marked virologic suppression. The patient's condition has been well controlled for nearly two years with good adherence. This case emphasizes the influence of ART treatment options on medication compliance and the outcome of HIV infection.
确诊感染艾滋病毒后，患者需要尽快开始终身抗逆转录病毒治疗（ART）。在艾滋病毒治疗期间，ART药物可能会引起无法耐受的不良反应，导致用药依从性差、治疗失败以及艾滋病毒病情进展。在此，我们报告一例因副作用而对多种抗病毒药物不耐受的艾滋病病例，最终我们使用阿比多尔（ABT）和多替拉韦（DTG）联合治疗使其病情稳定。一名48岁女性在开始ART治疗后的一个月内出现了顽固性恶心、呕吐和腹部不适。在四年的时间里，由于她对严重不良反应（主要是胃肠道症状、皮疹和嗜睡）不耐受，她被更换了四种不同的ART治疗方案。在这四年里，由于用药依从性差，她未能实现病毒抑制。经过几次ART方案的更换后，我们让她开始使用长效抗逆转录病毒治疗（LA ART），即阿比多尔联合多替拉韦，她对该方案耐受性良好。患者的一般状况显著改善，并实现了显著的病毒学抑制。在良好的依从性下，患者的病情已得到近两年的良好控制。该病例强调了ART治疗方案对用药依从性和艾滋病毒感染结局的影响。
