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首页> 外文期刊>AIDS Research and Human Retroviruses >Beneficial effects of a switch to a Lopinavir/ritonavir-containing regimen for patients with partial or no immune reconstitution with highly active antiretroviral therapy despite complete viral suppression.
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Beneficial effects of a switch to a Lopinavir/ritonavir-containing regimen for patients with partial or no immune reconstitution with highly active antiretroviral therapy despite complete viral suppression.

机译：尽管完全抑制了病毒，但仍采用高度积极的抗逆转录病毒疗法，对部分或完全没有免疫重建的患者，改用含Lopinavir / ritonavir的治疗方案具有有益效果。

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The purpose of this study was to determine if switching to an Lopinavir/ritonavir (LPV/r)-containing regimen resulted in greater immune reconstitution in patients with immunologic failure despite complete viral suppression with highly active antiretroviral therapy (HAART). Twenty patients with partial or no immune response to HAART despite viral suppression were enrolled. Ten were randomized to stay on their current regimen and 10 were randomized to LPV/r plus their current NRTI backbone. T cell subsets, ex vivo apoptosis, and the percent of circulating cells with detectable intracellular HIV-1 RNA were measured. The mean increase in CD4(+) count at 6 months was 116/mm(3) (172-288) for the LPV/r-containing arm versus 32/mm(3) (264-296) for continuation regimens (p = 0.03). The number of patients with an increase >/=50 cells/mm(3) was also greater in the LPV/r arm (7/9 versus 2/10, p = 0.01). This paralleled a decrease in ex vivo apoptosis of naive CD4(+) T cells at 6 months (21.7-11.0% for the LPV/r arm versus 17.3-18.9% for the continuation arm, p = 0.04) and memory cells (21.1-14.1% for LPV/r versus 20.2-17.9% for continuation arm, NSS). Switching patients to an LPV/r-containing regimen improved CD4(+) counts in patients with prior immunologic failure, and this may be due to an effect of LPV/r on apoptosis.
机译：这项研究的目的是确定尽管使用高效抗逆转录病毒疗法（HAART）完全抑制了病毒，但免疫功能衰竭患者转用含Lopinavir / ritonavir（LPV / r）的治疗方案是否会导致更大的免疫重建。招募了20例尽管有病毒抑制但对HAART有部分免疫反应或无免疫反应的患者。十名被随机分组​​以保留其当前方案，十名被随机分组​​为LPV / r加其当前的NRTI主链。测量了T细胞亚群，离体细胞凋亡以及可检测到的细胞内HIV-1 RNA的循环细胞百分比。含LPV / r的手臂在6个月时CD4（+）计数的平均增加为116 / mm（3）（172-288），而连续治疗方案为32 / mm（3）（264-296）（p = 0.03）。 LPV / r组中增加> / = 50个细胞/ mm（3）的患者数量也更大（7/9对2/10，p = 0.01）。这与6个月时幼稚CD4（+）T细胞的离体细胞凋亡减少相关（LPV / r组为21.7-11.0％，而连续组为17.3-18.9％，p = 0.04）和记忆细胞（21.1-1）。 LPV / r为14.1％，而延续臂NSS为20.2-17.9％。将患者切换为包含LPV / r的方案可改善先前有免疫功能衰竭的患者的CD4（+）计数，这可能是由于LPV / r对凋亡的影响。

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