...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Highly active antiretroviral therapy (HAART) retreatment in patients on CD4-guided therapy achieved similar virologic suppression compared with patients on continuous HAART: the HIV Netherlands Australia Thailand Research Collaboration 001.4 study.
【24h】

Highly active antiretroviral therapy (HAART) retreatment in patients on CD4-guided therapy achieved similar virologic suppression compared with patients on continuous HAART: the HIV Netherlands Australia Thailand Research Collaboration 001.4 study.

机译：与持续接受HAART的患者相比，接受CD4指导的患者进行的高活性抗逆转录病毒疗法（HAART）再治疗获得了相似的病毒学抑制：HIV荷兰澳大利亚泰国研究合作组织001.4研究。

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To assess the safety of 2 intermittent treatment strategies compared with continuous therapy for patients with virologic suppression on highly active antiretroviral therapy (HAART) at baseline. DESIGN: Seventy-four nucleoside reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) pretreated patients with an HIV RNA level <50 copies at screening were randomized to continuous treatment, CD4-guided treatment, or week-on-week-off treatment with 2 NRTIs plus 1600 mg/100 mg of saquinavir/ritonavir once daily. At week 96 (end of the randomized phase of the study), all patients were given continuous HAART for 12 weeks to week 108. Primary outcomes were the proportion of patients with a CD4 count >350 cells/microL and HIV RNA level <400 copies/mL at week 108. METHODS: Patients were followed up every 12 weeks for CD4 count, HIV RNA level, and clinical and laboratory toxicities. In the CD4-guided arm, treatment was stopped and restarted using a CD4 count threshold (above or below 350 cells/microL or reduction of 30%). RESULTS: Seventy-four patients were enrolled with a median CD4 count of 644 cells/microL before the structured treatment interruption (STI). The week-on-week-off arm (n=26) was discontinued at week 72 because of high rates (46%) of HIV RNA rebound above 50 copies/mL. In the continuous arm, 25 (100%) of 25 patients and 24 (96%) of 25 patients had an HIV RNA level <400 copies/mL and <50 copies/mL, respectively, at week 108, and 96% had a CD4 count above 350 cells/microL, with a median CD4 count of 661 cells/microL. Patients in the CD4-guided arm had a significantly lower median CD4 count (489 cells/microL) than the patients in the continuous arm (P=0.03), but all had a CD4 count above 350 cells/microL and 1 had a new HIV-related illness. At week 108, 21 (91%) of 23 patients and 13 (57%) of 23 patients had an HIV RNA level <400 copies/mL and <50 copies/mL, respectively. Those who did not achieve an HIV RNA level <50 copies/mL had a higher HIV RNA load before retreatment, and 4 of 5 patients subsequently achieved viral suppression after an additional 12 weeks of HAART (week 120). Therefore, 17 (94%) of 18 evaluable CD4-guided arm patients achieved viral suppression after retreatment. Antiretroviral (ARV) side effects were similar in all arms. CD4-guided treatment had a 54% ARV cost savings. CONCLUSIONS: This pilot study suggests that CD4-guided HAART is a well-tolerated and cost-saving treatment strategy for patients with high pre-ARV and pre-STI CD4 counts. Week-on-week-off treatment had a high virologic failure rate and was discontinued. The HIV RNA suppression rate was similar in patients treated with continuous HAART and in those retreated with 12 to 24 weeks of HAART after CD4-guided therapy.
机译：目的：评估基线时采用高活性抗逆转录病毒疗法（HAART）进行病毒学抑制的2种间歇治疗策略与连续治疗相比的安全性。设计：筛查HIV RNA水平<50个拷贝的74个核苷类逆转录酶抑制剂（NRTI）和蛋白酶抑制剂（PI）预处理的患者被随机分配至连续治疗，CD4指导治疗或每周停药治疗每天一次，含2种NRTI和1600 mg / 100 mg沙奎那韦/利托那韦。在第96周（研究的随机阶段结束），所有患者均接受连续HAART治疗，持续12周至108周。主要结局是CD4计数> 350细胞/微升且HIV RNA水平<400份的患者比例/ mL在第108周。方法：每12周对患者进行一次随访，检查其CD4计数，HIV RNA水平以及临床和实验室毒性。在CD4引导的手臂中，使用CD4计数阈值（高于或低于350个细胞/微升或减少30％）停止治疗并重新开始治疗。结果：在结构性治疗中断（STI）之前，有74名患者的CD4中位数为644个细胞/微升。由于HIV RNA反弹率高于50份/ mL，高比率（46％），因此在第72周时停止了每周一次的治疗（n = 26）。在连续臂中，第108周时25名患者中的25名（100％）和25名患者中24名（96％）的HIV RNA水平在108周时分别<400拷贝/ mL和<50拷贝/ mL，而96％的患者CD4计数高于350个细胞/微升，中值CD4计数为661个细胞/微升。 CD4引导组的患者的CD4中位数（489个细胞/微升）明显低于连续组（P = 0.03），但所有CD4计数均高于350个细胞/微升且1个患者感染了新的HIV相关疾病。在第108周时，23名患者中的21名（91％）和23名患者中的13名（57％）的HIV RNA水平分别<400拷贝/ mL和<50拷贝/ mL。 HIV RNA水平<50拷贝/ mL的患者在重新治疗之前具有较高的HIV RNA载量，每5名患者中有4名在接受HAART额外12周后（第120周）就实现了病毒抑制。因此，在18例可评估的CD4引导的手臂患者中，有17例（94％）在重新治疗后实现了病毒抑制。所有组的抗逆转录病毒（ARV）副作用均相似。 CD4指导的治疗可节省54％的ARV费用。结论：这项初步研究表明，CD4引导的HAART对于ARV前和STI前CD4计数高的患者是一种耐受良好且节省成本的治疗策略。每周一次的休假治疗具有较高的病毒学失败率，因此已终止。在CD4指导治疗后，连续HAART治疗的患者和12-24周的HAART治疗的患者的HIV RNA抑制率相似。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号