Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life.
Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life.
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DOI：
10.1016/j.jcv.2009.09.025
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发表时间：
2009-12
影响因子：
8.8
通讯作者：
Zolopa, Andrew R.
中科院分区：
文献类型：
--
作者：
Grant, Philip M.;Palmer, Sarah;Bendavid, Eran;Talbot, Annie;Slamowitz, Debbie C.;Cain, Pat;Kobayashi, Stacy S.;Balamane, Maya;Zolopa, Andrew R.
对于服用恩福韦肽后出现注射部位反应的病毒学抑制的HIV-1感染患者，雷替格拉韦是一种潜在的治疗选择。表征恩福韦特与雷替格拉韦转换的安全性和有效性，包括T细胞、生活质量和残留病毒血症的变化。在病毒载量<50拷贝/mL且有注射部位反应的患者中，将恩福韦肽改为雷替格拉韦，而无需对抗逆转录病毒治疗方案进行额外更改。病毒学失败被定义为病毒载量为1000拷贝/mL或连续两次病毒载量测量在50-1000拷贝/mL之间（低水平病毒血症）。在为期24周的研究中，我们比较了T细胞、注射部位反应、生活质量和残留病毒血症的变化，这些变化是通过单拷贝试验测量的，该试验可以检测到单个拷贝的血浆病毒，使用配对T检验。14例患者中位CD4+ t细胞计数为420细胞/μL。转换后，两名患者由于确诊的低水平病毒血症而经历病毒学失败。然而，两名患者随后都被重新抑制，其中一名患者的治疗方案没有任何改变。CD4+ t细胞计数无明显变化。注射部位反应消失。然而，生活质量几乎没有变化。残留病毒血症的基线中位水平为6拷贝/mL，在改用雷替重力韦后没有改变。在使用恩氟韦肽的病毒学抑制患者中，改用雷替韦可有效地维持24周的免疫和病毒学控制，但不会导致残留病毒血症的改变。
Raltegravir is a potential treatment option for virologically suppressed HIV-1 infected patients on enfuvirtide with injection site reactions. To characterize safety and efficacy of an enfuvirtride to raltegravir switch including changes in T cells, quality of life, and residual viremia. In patients with viral load<50 copies/mL and injection site reactions, enfuvirtide was switched to raltegravir without additional changes to the antiretroviral regimen. Virologic failure was defined as a viral load >1000 copies/mL or two consecutive viral load measurements between 50-1000 copies/mL (low-level viremia). Over the 24 week study, we compared changes in T cells, injection site reactions, quality of life, and residual viremia, as measured through the single-copy assay which can detect plasma virus down to a single copy, using paired t-tests. Fourteen patients with a median CD4+ T-cell count of 420 cells/μL were enrolled. After the switch, two patients experienced virologic failure due to confirmed low-level viremia. However, both patients subsequently were resuppressed, one without any changes to his regimen. There was no change in CD4+ T-cell count. Injection site reactions resolved. However, there was little reported change in quality of life. The baseline median level of residual viremia was 6 copies/mL and did not change after the switch to raltegravir. A switch to raltegravir in virologically suppressed patients on enfuvirtide is effective in maintaining immunologic and virologic control at 24 weeks but did not result in a change in residual viremia.
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影响因子：
168.9
作者：
Lennox, Jeffrey L.;Dejesus, Edwin;Sklar, Peter
通讯作者：
Sklar, Peter
影响因子：
158.5
作者：
Riddler, Sharon A.;Haubrich, Richard;Mellors, John W.
通讯作者：
Mellors, John W.
影响因子：
11.8
作者：
Gatell, Jose;Salmon-Ceron, Dominique;Ledesma, Emilio
通讯作者：
Ledesma, Emilio
DOI：
10.1056/nejmoa0803152
发表时间：
2008-10-02
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gulick RM;Lalezari J;Goodrich J;Clumeck N;DeJesus E;Horban A;Nadler J;Clotet B;Karlsson A;Wohlfeiler M;Montana JB;McHale M;Sullivan J;Ridgway C;Felstead S;Dunne MW;van der Ryst E;Mayer H;MOTIVATE Study Teams
通讯作者：
MOTIVATE Study Teams
影响因子：
158.5
作者：
Lalezari, JP;Henry, K;Hersch, J
通讯作者：
Hersch, J