Integrase inhibitor-based regimens result in more rapid virologic suppression rates among treatment-naïve human immunodeficiency virus-infected patients compared to non-nucleoside and protease inhibitor-based regimens in a real-world clinical setting: A retrospective cohort study.
Integrase inhibitor-based regimens result in more rapid virologic suppression rates among treatment-naïve human immunodeficiency virus-infected patients compared to non-nucleoside and protease inhibitor-based regimens in a real-world clinical setting: A retrospective cohort study.
复制标题
基于整合酶抑制剂的方案在未经治疗的人类免疫缺陷病毒感染的患者中与非核苷和蛋白酶抑制剂基于蛋白酶的临床环境相比，病毒性抑制率更快：回顾性队列研究。
DOI：
10.1097/md.0000000000013016
复制
发表时间：
2018-10
期刊：
影响因子：
1.6
通讯作者：
Ogbuagu O
中科院分区：
文献类型：
--
作者：
Jacobson K;Ogbuagu O
与含有蛋白酶抑制剂（PI）或非核苷类逆转录酶抑制剂（NNRTI）的方案相比，整合酶链转移抑制剂（CITI）类抗逆转录病毒治疗（ART）可能导致更快的病毒学抑制时间。然而，在使用当代抗逆转录病毒药物的常规临床环境中，达到病毒学抑制的时间差异并不明确。研究是一项回顾性单中心研究，研究对象为2013年至2016年期间开始ART治疗的初治人类免疫缺陷病毒（HIV）患者。在接受不同ART方案的患者中，我们比较了病毒学抑制率和中位时间[病毒载量（VL）<50拷贝/mL]。 共有155名患者（45名（29%）女性和110名（71%）男性）符合研究入选标准。中位年龄为42岁（四分位距31-52），中位基线CD 4计数为288个细胞/μL，VL为60，000拷贝/mL。 71例（46%）患者开始了基于INSTI的方案，58例（37%）患者接受了基于NNRTI的方案，26例（17%）患者接受了基于PI的方案。总共有112例（72%）患者在12个月时达到病毒学抑制。接受INSTI方案治疗的患者更有可能在3、6和12个月时达到病毒学抑制（P <0.01），并且中位抑制时间较短（60 vs NNRTI方案137天，PI方案147天，P <0.01）。 在现实世界中，接受基于INSTI的ART方案的患者的病毒学抑制率较高，从ART开始到病毒学抑制的时间较短。对于接受基于INSTI的ART方案治疗的HIV患者，在目前推荐的48周治疗前，VL>50拷贝/mL的患者应怀疑病毒学失败。
The integrase strand transfer inhibitor (INSTI) class of antiretroviral therapy (ART) may result in faster time to virologic suppression compared with regimens that contain protease inhibitors (PIs) or non-nucleoside reverse transcriptase inhibitors (NNRTIs). However, differences in time to achieve virologic suppression are not well-defined in routine clinical settings with contemporary antiretroviral agents. Study was a retrospective single-center study of treatment-naïve human immunodeficiency virus (HIV) patients initiating ART between 2013 and 2016. Among patients on different ART regimen types, we compared rates of and median time to virologic suppression [viral load (VL) <50 copies/mL]. A total of 155 patients—45 (29%) female and 110 (71%) male—met study inclusion criteria. Median age was 42 years (interquartile range 31–52), and median baseline CD4 count was 288 cells/μL and VL was 60,000 copies/mL. Seventy-one (46%) initiated an INSTI-based regimen, 58 (37%) were on NNRTI-based regimens, and 26 (17%) on PI-based regimens. In total, 112 (72%) patients achieved virologic suppression at 12 months. Patients on INSTI-based regimens were more likely to achieve virologic suppression by 3, 6, and 12 months (P < .01), and had lower median time to suppression (60 vs 137 days on NNRTI-based regimens and 147 days on PI-based regimens, P < .01). Patients on INSTI-based ART regimens in a real-world setting experienced higher rates of virologic suppression and shorter time from ART initiation to virologic suppression. For HIV patients on INSTI-based ART regimens, virologic failure should be suspected in those with VLs >50 copies/mL before the current recommendation of 48 weeks.