A review of the virological efficacy of the 4 World Health Organization-recommended tenofovir-containing regimens for initial HIV therapy.
A review of the virological efficacy of the 4 World Health Organization-recommended tenofovir-containing regimens for initial HIV therapy.
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DOI：
10.1093/cid/cir1034
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Shafer RW
中科院分区：
文献类型：
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作者：
Tang MW;Kanki PJ;Shafer RW
我们系统地回顾了2010年世界卫生组织抗逆转录病毒（ARV）治疗指南中推荐的一线替诺福韦方案。TDF/3TC/NVP研究最少，效果最差。TDF/3TC/NVP在广泛应用于初始抗逆转录病毒治疗之前需要进一步研究。（见Kuritzkes等人的社论。）我们系统地回顾了2010年世界卫生组织抗逆转录病毒治疗指南中推荐的用于初始抗逆转录病毒治疗的4种新的含替诺福韦（TDF）方案的病毒学疗效研究。33项研究评估了1种或1种以上含TDF方案的疗效：TDF/拉米夫定(3TC)/奈韦拉平（NVP） （n = 3）， TDF/恩曲他滨(FTC)/NVP (n = 9)， TDF/3TC/依非韦伦（EFV） （n = 6）， TDF/FTC/EFV （n = 19）。TDF/3TC/NVP是4种方案中研究最少且效果最差的。在2项比较研究中，TDF/3TC/NVP与病毒学失败的相关性明显高于AZT/3TC/NVP；第三项研究由于早期病毒学失败而过早终止。国家发展基金/联邦贸易委员会/国家发展基金与其比较国部门相当或较差。TDF/3TC/EFV与其比较武器相当。TDF/FTC/EFV相当于或优于其比较国家。对这些发现的可能解释包括EFV比NVP更强的抗病毒活性和ftc -三磷酸比3tc -三磷酸更长的细胞内半衰期。TDF/3TC/NVP在广泛应用于初始抗逆转录病毒治疗之前需要进一步研究。
We systematically reviewed the first-line tenofovir regimens recommended in the 2010 World Health Organization Antiretroviral (ARV) Treatment Guidelines. TDF/3TC/NVP was the least well-studied and appeared the least efficacious. Further study of TDF/3TC/NVP is required before it is widely deployed for initial ARV therapy. (See the Editorial Commentary by Kuritzkes et al, on pages .) We systematically reviewed studies of the virological efficacy of the 4 new tenofovir (TDF)-containing regimens recommended for initial antiretroviral (ARV) therapy in the 2010 World Health Organization ARV Treatment Guidelines. Thirty-three studies assessed the efficacy of 1 or more TDF-containing regimens: TDF/lamivudine (3TC)/nevirapine (NVP) (n = 3), TDF/ emtricitabine (FTC)/NVP (n = 9), TDF/3TC/efavirenz (EFV) (n = 6), and TDF/FTC/EFV (n = 19). TDF/3TC/NVP was the least well-studied and appeared the least efficacious of the 4 regimens. In 2 comparative studies, TDF/3TC/NVP was associated with significantly more virological failure than AZT/3TC/NVP; a third study was terminated prematurely because of early virological failure. TDF/FTC/NVP was either equivalent or inferior to its comparator arms. TDF/3TC/EFV was equivalent to its comparator arms. TDF/FTC/EFV was equivalent or superior to its comparator arms. Possible explanations for these findings include the greater antiviral activity of EFV versus NVP and longer intracellular half-life of FTC-triphosphate versus 3TC-triphosphate. Further study of TDF/3TC/NVP is required before it is widely deployed for initial ARV therapy.