Brodie S B, Keller M J, Ewenstein B M, Sax P E
Division of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA.
AIDS. 1998 Dec 24;12(18):2433-7. doi: 10.1097/00002030-199818000-00012.
Nephrolithiasis may be an important consequence of indinavir therapy; however little has been published on the variation in incidence between different populations of patients or the possible mechanisms of calculus formation.
To examine variation in the incidence of indinavir-associated nephrolithiasis (IAN) in HIV-positive patients in relation to hemophilia and hepatitis C virus (HCV) infection.
Clinical data were abstracted retrospectively from the medical records of all adult patients treated with indinavir from September 1995 to September 1997. Occurrence of first IAN, defined as flank pain and hematuria after initiation of therapy, was analyzed in relation to hemophilia status and HCV infection.
There were 17 episodes of IAN (22%) among 79 patients treated with indinavir. Of 10 patients with hemophilia, 50% developed IAN as compared with 17% of patients without hemophilia (P = 0.03). Median days to first IAN was 22 (range 7-110 days) for hemophiliacs and 156 (range 5-611 days) for those without hemophilia. Data for HCV status were available for 74 out of 79 patients: 10 out of 27 (37%) patients with HCV developed IAN compared with six out of 42 (14%) without HCV (P = 0.02).
Overall incidence of IAN was higher than that previously reported and was significantly greater in hemophiliacs than in non-hemophiliacs. HCV may be a contributing factor.
肾结石可能是茚地那韦治疗的一个重要后果；然而，关于不同患者群体中发病率的差异或结石形成的可能机制，鲜有文献报道。
研究HIV阳性患者中茚地那韦相关性肾结石（IAN）发病率与血友病及丙型肝炎病毒（HCV）感染的关系。
回顾性分析1995年9月至1997年9月期间所有接受茚地那韦治疗的成年患者的病历。分析首次IAN的发生情况，定义为治疗开始后出现侧腹痛和血尿，并与血友病状态及HCV感染相关。
79例接受茚地那韦治疗的患者中有17例发生IAN（22%）。10例血友病患者中，50%发生IAN，而无血友病患者中这一比例为17%（P = 0.03）。血友病患者首次发生IAN的中位天数为22天（范围7 - 110天），无血友病患者为156天（范围5 - 611天）。79例患者中有74例有HCV状态数据：27例HCV患者中有10例（37%）发生IAN，而42例无HCV患者中有6例（14%）发生IAN（P = 0.02）。
IAN的总体发病率高于先前报道，血友病患者的发病率显著高于非血友病患者。HCV可能是一个促成因素。
