Chronic ethanol use in alcoholic beverages by HIV-infected patients affects the therapeutic window of stavudine, lamivudine and nevirapine during the 9-month follow-up period: using chronic alcohol-use biomarkers.
Chronic ethanol use in alcoholic beverages by HIV-infected patients affects the therapeutic window of stavudine, lamivudine and nevirapine during the 9-month follow-up period: using chronic alcohol-use biomarkers.
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DOI：
10.1515/jbcpp-2013-0089
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发表时间：
2014-01-27
影响因子：
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通讯作者：
Ntale, Muhammad
中科院分区：
文献类型：
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作者：
Bbosa, Godfrey S;Kyegombe, David B;Ntale, Muhammad
摘要背景：长期使用乙醇是一个全球性问题，包括使用司他夫定/拉米夫定/奈韦拉平 (d4T/3TC/NVP) 方案的 HIV 感染患者。该研究使用酒精使用生物标志物来筛查患者是否长期使用乙醇，从而确定了长期使用乙醇对 HIV 感染患者的 d4T、3TC 和 NVP 治疗窗的影响。方法：采用重复测量设计和连续测量的病例对照研究来量化血浆中的药物。世界卫生组织酒精使用障碍识别测试（AUDIT）工具最初用于筛查患者是否长期饮酒，然后使用酒精使用生物标志物（γ-谷氨酰转移酶≥55.0 IU；平均红细胞体积≥96 fl，天冬氨酸转氨酶/丙氨酸转氨酶比率≥2.0值）对他们进行进一步分类。共有 41 名患者（酒精组 26 名，对照组 15 名）接受了为期 9 个月的随访，每隔 3 个月进行一次血液采样。使用 Shimadzu Class-VP HPLC 数据系统 6.1 版对血浆药物浓度进行定量。使用SAS 2003 9.1版统计包和重复测量固定模型对数据进行分析。使用学生 t 检验比较平均值。结果：在9个月的随访期间，酒精组的d4T和3TC平均稳态血浆药物浓度低于对照组。对于3TC，在6个月和9个月的随访期间，酒精组和对照组之间的平均稳态血浆药物浓度存在统计学差异（p≤0.05）。对于 NVP，尽管酒精组的药物血浆浓度高于对照组且具有统计学意义，但两组均在参考范围内（p
Abstract Background: Chronic ethanol use is a global problem including among HIV-infected patients on stavudine/lamivudine/nevirapine (d4T/3TC/NVP) regimen. The study determined the effect of chronic ethanol use on the therapeutic window of d4T, 3TC and NVP in HIV-infected patients using alcohol-use biomarkers to screen patients for chronic ethanol use. Methods: A case-control study using repeated measures design with serial measurements was used to quantify drugs in plasma. The WHO alcohol use disorder identification test (AUDIT) tool was initially used to screen patients for chronic alcohol use, and then they were further sorted using alcohol-use bioamarkers (gamma-glutamyl transferase ≥55.0 IU; mean corpuscular volume, ≥96 fl, aspartate amino transferase/alanine aminotransferase ratio ≥2.0 value). A total of 41 patients (26 in the alcohol group and 15 in the control group) were followed up for 9 months with blood sampling done at 3-month intervals. Plasma drug concentrations were quantified using a Shimadzu Class-VP HPLC data system version 6.1. Data was analyzed using SAS 2003 version 9.1 statistical package with repeated measures fixed model. Means were compared using Student's t-test. Results: The mean steady-state plasma drug concentrations of d4T and 3TC in the alcohol group were lower than that in the control group during the 9-month period of follow-up. For 3TC, there was a statistical difference in the mean steady-state plasma drug concentrations between the alcohol group and the control group (p≤0.05) in the 6- and 9-month period of follow-up. For NVP, in both groups they were within the reference ranges, although the drug plasma concentrations were higher in the alcohol group compared to the control group and were statistically significant (p