Comparison of two antiretroviral triple combinations including the protease inhibitor indinavir in children infected with human immunodeficiency virus.
Comparison of two antiretroviral triple combinations including the protease inhibitor indinavir in children infected with human immunodeficiency virus.
复制标题
比较两种抗逆转录病毒三联药物（包括蛋白酶抑制剂茚地那韦）对感染人类免疫缺陷病毒的儿童的影响。
DOI：
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
B. Belohradsky
中科院分区：
文献类型：
--
作者：
U. Wintergerst;F. Hoffmann;B. Sölder;G. Notheis;T. Petropoulou;J. Eberle;L. Gürtler;B. Belohradsky
客观化
评估两种抗逆转录病毒三联用药(包括蛋白酶抑制剂吲地那韦)对替代标志物、病毒载量和CD4细胞的影响。
方法
15例病毒载量高或既往接受抗逆转录病毒治疗后病情进展的患者改用齐多夫定/拉米夫定/吲地那韦(A组，n=10)或司他夫定/拉米夫定/吲地那韦(B组，n=5)。连续测定病毒载量和CD_4细胞。
结果
A组3个月后病毒载量下降的中位数为0.6log，6个月后为0.8log，B组3个月和6个月后病毒载量下降的中位数分别为2.5和2.4log。3个月和6个月后，A组10名患者中有3名患者和B组5名患者中有3名患者的病毒载量下降到检测下限以下。在依地那韦治疗开始时额外切换核苷类似物的患者(不管使用的是哪种特定的逆转录酶抑制剂)比没有切换的患者的病毒载量的降低要好得多(6个月后，中位数为2.3log，6个月后为0.2log，P<；0.05)。A组3个月后CD_4细胞相对增加的中位数为37%，6个月后的中位数为57%(P=0.002)，B组CD_4细胞相对增加的中位数分别为145%和163%(P<0.05)。A组2例，B组1例发生肾结石，充分水化后结石消失。一名患者因依地那韦引起的顽固性呕吐而退出治疗。
结论
在接受过广泛抗逆转录病毒治疗的一小部分感染艾滋病毒的儿童患者中，包括依地那韦在内的三联疗法在降低病毒载量和增加CD4细胞方面具有持久的效果，与在有抗逆转录病毒经验的成年人中获得的结果相似。在三联疗法开始时，有额外核苷类似物切换的患者比没有这种变化的患者的效果要好得多。
OBJECTIVE
The effects of two antiretroviral triple combinations including the protease inhibitor indinavir on the surrogate markers, viral load and CD4 cells were evaluated.
METHODS
Fifteen patients with high viral load or disease progression under their prior antiretroviral therapy were switched to zidovudine/lamivudine/indinavir (Group A, n = 10) or stavudine/lamivudine/indinavir (Group B, n = 5). Serial determinations of viral load and CD4 cells were performed.
RESULTS
The median reduction of the viral load was 0.6 log after 3 months and 0.8 log after 6 months in Group A and 2.5 and 2.4 log after 3 and 6 months in Group B, respectively. After 3 and 6 months 3 of 10 patients in Group A and 3 of 5 patients in Group B had viral load reductions below the detection limit of the assay. Patients with an additional switch of nucleoside analogues at start of indinavir therapy (regardless of the specific reverse transcriptase inhibitor used) had significantly better reductions of the viral load than patients without such a switch (median 2.3 log vs. 0.2 log after 6 months, P < 0.05). In Group A the median of the relative increase of CD4 cells was 37% after 3 months and 57% after 6 months (P = 0.002); in Group B the medians of the relative increase of CD4 cells were 145 and 163% (not significant), respectively. Two patients from Group A and 1 from Group B developed renal calculi, which resolved after adequate hydration. One patient was withdrawn because of intractable vomiting attributed to indinavir.
CONCLUSION
In a small cohort of HIV-infected pediatric patients with extensive prior antiretroviral treatment, triple therapy including indinavir had a sustained effect on the decrease of the viral load and the increase of CD4 cells similar to results obtained in antiretrovirally experienced adults. This effect was significantly better in patients with an additional switch of a nucleoside analogue at start of triple therapy with indinavir than in patients without such a change.
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影响因子：
158.5
作者：
Gulick, RM;Mellors, JW;Chodakewitz, JA
通讯作者：
Chodakewitz, JA
影响因子：
158.5
作者：
Collier, AC;Coombs, RW;Corey, L
通讯作者：
Corey, L
通过培养和聚合酶链反应对齐多夫定长期治疗后对去羟肌苷的反应进行人类免疫缺陷病毒定量。
DOI：
10.1093/infdis/169.2.416
发表时间：
1994
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Katzenstein,DA;Winters,M;Bubp,J;Israelski,D;Winger,E;Merigan,TC
通讯作者：
Merigan,TC
用蛋白酶抑制剂治疗患有晚期人类免疫缺陷病毒 1 型疾病的儿童的临床、病毒学和免疫学反应。
DOI：
10.1097/00006454-199710000-00013
发表时间：
1997
期刊：
The Pediatric infectious disease journal
影响因子：
--
作者：
Melvin,AJ;Mohan,KM;Arcuino,LA;Edelstein,RE;Frenkel,LM
通讯作者：
Frenkel,LM