Rhone S A, Hogg R S, Yip B, Sherlock C, Conway B, Schechter M T, O'Shaughnessy M V, Montaner J S
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
AIDS. 1998 Apr 16;12(6):619-24. doi: 10.1097/00002030-199806000-00011.
To characterize the antiviral effect and predictors of response to ritonavir and saquinavir-based antiretroviral combination therapy.
Intent-to-treat analysis with suppression of plasma viral load to levels below 2.7 log10 copies/ml as the main outcome measure.
All adult HIV-positive individuals in the province of British Columbia who started taking ritonavir and saquinavir (each at 600 mg twice daily) in combination from 1 September 1996 to 28 February 1997, with a minimum of two plasma viral load measurements, one at baseline and one after the initiation of therapy.
A total of 58 participants were prescribed ritonavir and saquinavir. The median plasma viral load at entry was 4.80 log10 copies/ml (interquartile range, 4.51-5.15 log10 copies/ml). A total of 29 (50%) subjects demonstrated a decrease in plasma viral load to levels below 2.7 log10 copies/ml. This level of suppression was associated with higher baseline CD4 cell counts (P=0.022) and no prior exposure to protease inhibitors (P=0.001). After controlling for baseline CD4 cell count and plasma viral load, participants naive to protease inhibitors were almost seven times (odds ratio, 6.99; 95% confidence interval, 1.85-26.39; P=0.004) more likely to suppress their plasma viral load to below 2.7 log10 copies/ml than those who had previously used protease inhibitors.
Our analysis demonstrates that a ritonavir and saquinavir-based combination can produce a substantial decrease in plasma viral load with half of the participants decreasing their plasma viral load to below the limit of quantification of the assay. This response, however, is seriously compromised by prior exposure to protease inhibitors.
描述基于利托那韦和沙奎那韦的抗逆转录病毒联合疗法的抗病毒效果及反应预测因素。
意向性分析，以将血浆病毒载量抑制至低于2.7 log10拷贝/毫升为主要结局指标。
1996年9月1日至1997年2月28日在不列颠哥伦比亚省开始联合服用利托那韦和沙奎那韦（均为每日两次，每次600毫克）的所有成年HIV阳性个体，至少进行两次血浆病毒载量测量，一次在基线时，一次在治疗开始后。
共有58名参与者被处方利托那韦和沙奎那韦。入组时血浆病毒载量中位数为4.80 log10拷贝/毫升（四分位间距，4.51 - 5.15 log10拷贝/毫升）。共有29名（50%）受试者血浆病毒载量降至低于2.7 log10拷贝/毫升。这种抑制水平与更高的基线CD4细胞计数相关（P = 0.022）且之前未接触过蛋白酶抑制剂（P = 0.001）。在控制基线CD4细胞计数和血浆病毒载量后，未接触过蛋白酶抑制剂的参与者将血浆病毒载量抑制至低于2.7 log10拷贝/毫升的可能性几乎是之前使用过蛋白酶抑制剂者的7倍（优势比，6.99；95%置信区间，1.85 - 26.39；P = 0.004）。
我们的分析表明，基于利托那韦和沙奎那韦的联合疗法可使血浆病毒载量大幅下降，半数参与者的血浆病毒载量降至检测定量限以下。然而，之前接触过蛋白酶抑制剂会严重影响这种反应。
