Successful optimization of antiretroviral regimens in treatment-experienced people living with HIV undergoing liver transplantation.
Successful optimization of antiretroviral regimens in treatment-experienced people living with HIV undergoing liver transplantation.
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在经历过治疗且接受肝移植的艾滋病毒感染者中成功优化抗逆转录病毒治疗方案。
DOI：
10.1111/tid.13174
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Karris,MaileY
中科院分区：
文献类型：
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作者：
Waldman,Georgina;Rawlings,StephenA;Kerr,Janice;Vodkin,Irine;Aslam,Saima;Logan,Cathy;Dan,Jennifer;Mehta,Sanjay;Hill,Lucas;Karris,MaileY
现代抗逆转录病毒疗法延长了艾滋病毒感染者的预期寿命。然而，大多数年龄较大的PLWH（≥50岁）“老化”艾滋病毒，并暴露于历史的艾滋病毒护理实践和旧的，毒性更大的ART。在PLWH暴露于旧的和多种ART方案，ART经常用于治疗经验丰富的人和常用的免疫抑制剂之间的药物相互作用仍然是一个重大挑战。然而，较新的ART类别（例如整合酶非链转移抑制剂）和更先进的HIV遗传耐药性检测的出现可能会优化ART方案，同时减少药物相互作用。在这里，我们提出了一个病例系列的三个PLWH的复杂的ART相互作用（或相互作用的风险）与他们的肝移植后免疫抑制。在对他们的前病毒DNA耐药性测试进行审查后，他们成功地过渡到更安全的含整合酶非链转移抑制剂的ART方案，没有病毒信号或器官排斥的证据。
Modern antiretroviral therapy (ART) extends life expectancy for people living with HIV (PLWH). However, most older PLWH (≥50 years) “aged” with HIV and were exposed to historical HIV care practices and older, more toxic ART. In PLWH with exposure to older and multiple ART regimens, the drug interactions between ART frequently used in treatment‐experienced persons and commonly used immunosuppressants remain a significant challenge. However, the advent of newer ART classes (eg, integrase non‐strand transfer inhibitors) and more advanced HIV genetic resistance testing may allow optimization of ART regimens with minimal drug interactions. Here, we present a case series of three PLWH whose complicated ART interacted (or was at risk for interacting) with their post–liver transplant immunosuppression. After a review of their proviral DNA resistance testing, they successfully transitioned onto safer integrase non‐strand transfer inhibitor‐containing ART regimens without viral blips or evidence of organ rejection.