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中国南京HIV感染者每两个月改用长效注射用卡博特韦和rilpivirine的意愿。

Willingness to Switch to Long-Acting Injectable Cabotegravir and Rilpivirine Every 2 Months for People Living with HIV in Nanjing, China.

作者信息

Li Mengqing, Guan Hongjing, Zhong Mingli, Di Xiaoyun, Yu Nawei, Chen Chen, Cai Rentian, Wei Hongxia

机构信息

Department of Infectious Disease, The School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, China.

Department of Infectious Disease, The Second Hospital of Nanjing, Nanjing, China.

出版信息

AIDS Res Hum Retroviruses. 2025 Feb;41(2):107-112. doi: 10.1089/aid.2023.0150. Epub 2024 Dec 12.

Abstract

Daily oral medication is currently the most common antiretroviral therapy (ART) for people living with human immunodeficiency virus (PLWH). As the first complete long-acting (LA) ART regimen, cabotegravir (CAB) and rilpivirine (RPV), offer a novel treatment approach with less frequent administration, via bimonthly infusion. Due to the upcoming availability of this regimen in China, the study aimed to analyze the willingness and reasons of PLWH to switch to CAB+RPV therapy. A questionnaire survey among PLWH receiving oral ART was carried out between March 25 and April 8, 2023, in the Second Hospital of Nanjing, China. Participants were asked about their willingness to switch to the CAB+RPV LA regimen and provided reasons for their decision. We analyzed the reasons for switching, and the factors affecting their willingness were analyzed by multinomial logistic regression. Among 693 participants, 56.7% expressed willingness to switch to the CAB+RPV regimen, 32.6% were uncertain, and 10.7% were unwilling. The primary reason for switching to CAB+RPV therapy was not being concerned about daily adherence to ART (22.6%). Uncertainty about switching was mainly associated with participants' concerns in terms of price (31.6%) and safety (31.1%) of the novel drugs. Unwillingness was mainly due to participants' satisfaction with their current treatment regimen (20.3%). In multivariate analysis, higher education (odds ratio []: 2.990; 95% confidence interval []: 1.171-7.636) was positively associated with willingness to switch, whereas the age of ≥60 (: 0.142; 95% : 0.036-0.554) was negatively associated. Our survey demonstrated that the majority of PLWH were willing to switch to CAB+RPV therapy, mainly due to its improved convenience and reduced risk of disease exposure. However, their concerns regarding price, efficacy, and safety could be the key challenges for the clinical implementation of the CAB+RPV LA regimen in the future.

摘要

目前,每日口服药物是人类免疫缺陷病毒感染者(PLWH)最常见的抗逆转录病毒疗法(ART)。作为首个完整的长效(LA)ART方案,卡博特韦(CAB)和利匹韦林(RPV)通过每两个月一次的注射,提供了一种给药频率较低的新型治疗方法。鉴于该方案即将在中国上市,本研究旨在分析PLWH转向CAB+RPV治疗的意愿及原因。2023年3月25日至4月8日,在中国南京医科大学第二附属医院对接受口服ART的PLWH进行了问卷调查。询问参与者转向CAB+RPV长效方案的意愿,并提供其决定的理由。我们分析了转向的原因,并通过多项逻辑回归分析了影响其意愿的因素。在693名参与者中,56.7%表示愿意转向CAB+RPV方案,32.6%不确定,10.7%不愿意。转向CAB+RPV治疗的主要原因是不担心每日坚持ART治疗(22.6%)。转向的不确定性主要与参与者对新药价格(31.6%)和安全性(31.1%)的担忧有关。不愿意主要是因为参与者对当前治疗方案满意(20.3%)。在多变量分析中,高等教育程度(比值比[]:2.990;95%置信区间[]:1.171-7.636)与转向意愿呈正相关,而年龄≥60岁(:0.142;95%:0.036-0.554)与转向意愿呈负相关。我们的调查表明,大多数PLWH愿意转向CAB+RPV治疗,主要是因为其便利性提高和疾病暴露风险降低。然而,他们对价格、疗效和安全性的担忧可能是未来CAB+RPV长效方案临床实施的关键挑战。

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