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首页> 外文期刊>AIDS Research and Human Retroviruses >Short communication: Lamivudine plus a boosted-protease inhibitor as simplification strategy in HIV-infected patients: Proof of concept
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Short communication: Lamivudine plus a boosted-protease inhibitor as simplification strategy in HIV-infected patients: Proof of concept

机译：简短交流：拉米夫定加增强蛋白酶抑制剂作为HIV感染患者的简化策略：概念验证

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摘要

There are scarce data about the use of a dual therapy with lamivudine plus a ritonavir-boosted protease inhibitor (PI/r) as simplification strategy. We performed a retrospective cohort study of 44 HIV-infected patients on suppressive triple therapy PI/r-based HAART, HBV negative, who discontinued one nucleoside analogue (NA) due to toxicity, and continued dual therapy with lamivudine plus the PI/r. The median time of HIV infection was 18.6 years, and CD4+ count nadir was 150 cells/μl (6-470). They had received a mean of four regimens before (2-20), and 55% had a previous AIDS diagnosis. In eight cases, a previous resistance test showed two to seven secondary mutations in the protease gene, without resistance to the PI/r. The 184V mutation was not observed, but previous failure with a lamivudine-including regimen had been observed in four patients (9%). At baseline, patients had viral suppression (50 copies/ml) for a median time of 794 days (235-2344), while receiving atazanavir/r in five cases, lopinavir/r in 14, and darunavir/r in 25. They discontinued mainly tenofovir (19, 43%) and didanosine (15, 34%). During 101.5 patient-years of follow-up, only two patients failed (5%), because of incomplete adherence. CD4+ count increase at 48 weeks was 55 cells/μl. No new adverse events were observed, although total cholesterol and triglycerides increased significantly during the first 6 months after simplification. In conclusion, dual therapy with lamivudine plus a boosted PI was safe and effective as simplification strategy in patients with toxicity to NA. This combination could be an alternative to mono or triple therapy in hard-to-treat patients.
机译：关于拉米夫定加利托那韦增强蛋白酶抑制剂（PI / r）双重疗法作为简化治疗策略的资料很少。我们对44例HIV感染患者进行了回顾性队列研究，他们采用基于PI / r的抑制性三联疗法HAART，HBV阴性，由于毒性而终止了一个核苷类似物（NA），并继续使用拉米夫定加PI / r双重疗法。 HIV感染的中位时间为18.6年，CD4 +计数最低点为150细胞/μl（6-470）。他们在（2-20）之前平均接受了4种治疗方案，其中55％曾接受过AIDS诊断。在八种情况下，先前的抗药性测试显示蛋白酶基因中有2至7个次级突变，而对PI / r无抗药性。没有观察到184V突变，但是在四名患者中观察到先前使用拉米夫定的方案失败（9％）。在基线时，患者接受病毒抑制（<50拷贝/ ml）的中位时间为794天（235-2344），同时接受阿扎那韦/ r 5例，洛匹那韦/ r 14例和达鲁那韦/ r 25例。主要停用替诺福韦（19，43％）和去羟肌苷（15，34％）。在101.5患者-年的随访期间，由于不完全依从性，只有2例患者失败（5％）。 48周时CD4 +计数增加为55细胞/μl。尽管在简化后的前6个月总胆固醇和甘油三酸酯明显增加，但未观察到新的不良事件。总之，拉米夫定加强化PI的双重疗法是安全且有效的简化NA毒性患者的简化策略。这种组合可以替代难以治疗的患者的单药或三药疗法。

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