HIV TRIALS

在目前用于设置HLV-1感染的各种终点中， CD4细胞计数是研究最广泛的替代标记物 并可能预测抗逆转录病毒治疗的临床效果。 在某些情况下，它与临床结果高度相关 不同时间点的抗逆转录病毒治疗。然而，它并没有 总是与临床事件相关，这表明 抗逆转录病毒治疗可能至少部分归因于 反映在抗逆转录病毒治疗对CD4细胞计数的影响上。在……里面 在这方面，有数据表明，病毒载量代表着一个主要的 HLV-1相关疾病严重程度的决定因素 随着免疫恶化的阶段和进展。HIV-1 用聚合酶链式反应测定的颗粒数量有 据报道，病毒血症的状态和病毒载量反映了患有 HIV-1感染，可能成为监测的潜在临床标志物 抗逆转录病毒治疗的病程和疗效。 最近有研究表明，同时给药的治疗方法 齐多夫定和二磷酸核苷可使CD4持续升高 细胞在一段时间内用这两种药物交替治疗 一年，建议抗HIV-1药物的剂量时间表可以是 这是一个重要的变量。在这项研究中，我们检查了病毒血症的变化。 26例非霍奇金淋巴瘤患者的药物相关突变水平及进展 有症状的HIV-1感染参与一项随机试验 交替或同时进行的AZT和DDI疗法。病人在 两组患者的血清RNA拷贝数均较基线显著降低 在这两年的研究中。两者之间的显著差异 在最初的2-3个月的治疗中，展示了两只手臂。分析 套式聚合酶链式反应结果表明，双链构象多态基因的出现是一种新的遗传方式。 相关的Leu74/Eval突变在两种方案中都被显著阻止 而AZT相关突变第215位密码子的突变不受影响。 抗病毒剂抗病毒作用总体持久性的测定 AZT和DDL交替和同步方案与临床 这些结果的含义需要进一步研究。

Among various endpoints currently used in the setting of HlV-1 infection, CD4 cell count represents the most extensively studied surrogate marker and might be predictive of the clinical effects of antiretroviral therapy. In some situations, it is highly correlated with clinical outcome at various points of time of antiretroviral therapy. However, it does not always correlate with clinical events, suggesting that the benefits of antiretroviral therapy may be due, at least in part, to factors not reflected in the effect of antiretroviral therapy on CD4 cell counts. In this regard, there are data suggesting that viral load represents a major determinant of the severity of HlV-1 related diseases and is associated with the stage and progression of immunological deterioration. HIV-1 particle numbers determined by using the polymerase chain reaction have been reported to reflect viremia status and viral load in individuals with HIV-1 infection and may serve as a potential clinical marker to monitor the disease process and effectiveness of antiretroviral therapy. It has recently been shown that therapy with simultaneous administration of zidovudine and didanosine provides more sustained elevation in CD4 cells than alternating therapy with the two agents over a time period of one year, suggesting that the dosing schedule of anti-HIV-1 drugs can be an important variable. In this study, we examined the changes in viremia levels and the development of drug-related mutations in 26 patients with symptomatic HIV-1 infection participating on a randomized trial comparing an alternating or simultaneous regimen of AZT and ddI therapy. Patients on both arms had significant reduction in serum RNA copies from baseline throughout the two years of the study. Significant differences between the two arms were demonstrated over the first 2-3 months of therapy. Analyses employing the nested PCR method revealed that the emergence of the ddI- related Leu74/EVal mutation was significantly blocked in both regimens while that of the AZT-related mutation at codon 215 was not affected. Determination of the overall durability of the anti-viremic effect of the alternating and simultaneous regimens of AZT and ddl and clinical implications of the results require further research.