Short-cycle therapy in adolescents after continuous therapy with established viral suppression: the impact on viral load suppression.
Short-cycle therapy in adolescents after continuous therapy with established viral suppression: the impact on viral load suppression.
复制标题
青少年在已建立病毒抑制的连续治疗后进行短周期治疗：对病毒载量抑制的影响。
DOI：
10.1089/aid.2008.0203
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发表时间：
2009
影响因子：
1.5
通讯作者：
AdolescentTrialsNetworkforHIV/AIDSInterventions
中科院分区：
文献类型：
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作者：
Rudy,BretJ;Sleasman,John;Kapogiannis,Bill;Wilson,CraigM;Bethel,James;Serchuck,Leslie;Ahmad,Sushma;Cunningham,ColeenK;AdolescentTrialsNetworkforHIV/AIDSInterventions
这是一项原理验证研究，旨在评估短周期治疗（SCT；治疗 4 天/休息 3 天）对病毒抑制良好的青少年和年轻人的影响，而基于蛋白酶抑制剂的抗逆转录病毒治疗方案具有良好的病毒抑制效果。受试者由艾滋病毒/艾滋病干预青少年试验网络和儿科艾滋病临床试验组招募。受试者通过围产期/幼儿期传播或后来通过危险行为被感染。所有受试者都必须有至少 6 个月的记录在案的病毒抑制低于 400 拷贝/毫升，加上进入前值低于 200 拷贝/毫升和进入 CD4+T 细胞计数高于 350 细胞/毫米 3。在登记的 32 名受试者中，12 名受试者 (37.5%) 确认病毒载量反弹超过 400 份，其中 18 名受试者 (56%) 因任何原因退出。当重新使用相同的药物进行连续治疗时，大多数受试者会再次受到抑制。尽管早期传播组和晚期传播组之间的病毒学反弹率没有差异，但那些生命早期感染的人因任何原因停止 SCT 的比率较高。对于仍在研究中或因任何原因停止 SCT 的患者，SCT 对 CD4+T 细胞计数没有影响。受试者表现出对 SCT 方案的良好依从性。这项研究表明，对于某些感染 HIV 的青少年和年轻人群体，可能需要进一步评估 SCT。
This was a proof-of-principle study to evaluate the impact of short cycle therapy (SCT; 4 days on/3 days off) in adolescents and young adults with good viral suppression on a protease inhibitor-based antiretroviral regimen. Subjects were recruited by the Adolescent Trials Network for HIV/AIDS Interventions and the Pediatric AIDS Clinical Trials Group. Subjects were infected either through perinatal/early childhood transmission or later via risk behaviors. All subjects were required to have at least 6 months of documented viral suppression below 400 copies/ml plus a preentry value below 200 copies/ml and an entry CD4+T cell count above 350 cells/mm3. Of the 32 subjects enrolled, 12 (37.5%) had confirmed viral load rebound >400 copies, with 18 subjects (56%) coming off for any reason. The majority of subjects resuppressed when placed back onto continuous therapy using the same agents. Although no difference was found in virologic rebound rates between the early and later transmission groups, those infected early in life had higher rates of coming off SCT for any reason. There was no impact of SCT on the CD4+T cell counts in those who remained on study or those who came off SCT for any reason. Subjects demonstrated good adherence to the SCT regimen. This study suggests that further evaluation of SCT may be warranted in some groups of adolescents and young adults infected with HIV.