长效抗逆转录病毒疗法的有效性和患者满意度的患者问卷调查：来自真实世界的数据。

Long-acting antiretroviral therapy effectiveness and patient satisfaction using patient questionnaires: data from a real-world setting.

机构信息

Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan.

Department of Post-Infectious Disease Therapeutics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

出版信息

BMC Infect Dis. 2024 Sep 16;24(1):979. doi: 10.1186/s12879-024-09904-x.

DOI:10.1186/s12879-024-09904-x

PMID:39278923

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404019/

Abstract

BACKGROUND

Antiretroviral therapy (ART) for HIV infection has evolved substantially. The development of long-acting drugs, such as cabotegravir (CAB) and rilpivirine (RPV) might improve treatment satisfaction among people living with HIV (PLWH). The real-world effectiveness of long-acting ART and its effect on patient satisfaction needs to be assessed. This study investigated antiviral effectiveness and treatment satisfaction in PLWH who switched from conventional to long-acting ART (CAB + RPV).

METHODS

This prospective cohort study included PLWH aged 18 years and older who switched to CAB + RPV and received the injections every 8 weeks between June 2022 and May 2023, after a 4-week oral lead-in phase. The eligibility criteria included viral suppression, absence of hepatitis B virus (HBV) DNA, and no prior RPV resistance mutations. Clinical data, including renal, lipid, and glucose biomarker levels, were monitored from the baseline to 44 weeks after switching. Treatment satisfaction was assessed using the HIV Treatment Satisfaction Questionnaire. A linear mixed-effects model was used to estimate changes in clinical data from baseline.

RESULTS

Thirty-eight male participants were enrolled. Some participants had detectable levels of viral replication; however, all participants maintained viral suppression (HIV-RNA < 50 copies/mL) at 44 weeks and no cases of virological failure were detected. The creatinine level decreased by - 0.04 mg/dL (95% confidence interval [CI]: - 0.07 to - 0.01), lipid and glucose profiles remained stable, and treatment satisfaction increased by 6.6 points (95% CI: 2.4 to 10.8) after switching to CAB + RPV.

CONCLUSIONS

Long-acting ART provides effective viral suppression and enhances treatment satisfaction in PLWH switching from conventional ART. Long-acting ART can improve patient well-being; however, patient selection and monitoring to prevent HBV-related complications are important.

摘要

背景

抗逆转录病毒疗法（ART）治疗 HIV 感染已取得显著进展。长效药物的发展，如卡替拉韦（CAB）和利匹韦林（RPV），可能会提高 HIV 感染者（PLWH）的治疗满意度。长效 ART 的实际效果及其对患者满意度的影响需要进行评估。本研究调查了从传统 ART 转换为长效 ART（CAB+RPV）的 PLWH 的抗病毒效果和治疗满意度。

方法

这是一项前瞻性队列研究，纳入了 2022 年 6 月至 2023 年 5 月期间转换为 CAB+RPV 并接受每 8 周注射一次的年龄在 18 岁及以上的 PLWH，并进行了为期 4 周的口服导入期。入选标准包括病毒抑制、乙型肝炎病毒（HBV）DNA 阴性以及无先前 RPV 耐药突变。从基线到转换后 44 周，监测包括肾、脂、糖生物标志物水平在内的临床数据。使用 HIV 治疗满意度问卷评估治疗满意度。采用线性混合效应模型估计从基线开始的临床数据变化。

结果

纳入了 38 名男性参与者。部分参与者的病毒复制水平可检测，但所有参与者在 44 周时均维持病毒抑制（HIV-RNA<50 拷贝/mL），未发现病毒学失败病例。肌酐水平降低了-0.04mg/dL（95%置信区间[CI]：-0.07 至-0.01），脂、糖谱保持稳定，转换为 CAB+RPV 后治疗满意度增加了 6.6 分（95%CI：2.4 至 10.8）。