多替拉韦钠+拉米夫定两药方案在初治HIV感染/AIDS患者的临床观察  

Efficacy observation of the two-drug regimen DTG+3TC in treatment-naive human immunodeficiency virus infection/acquired Immure deficiency syndrome patients

作　　者：兰双来 蓝珂 张勇 窦艳云 Lan Shuanglai;Lan Ke;Zhang Yong;Dou Yangyun(Department of Infection Disease,Chest Hospital of Guangxi Zhuang Autonomous Region,Guangxi Liuzhou 545005,China)

机构地区：[1]广西壮族自治区胸科医院感染科,广西柳州545005

出　　处：《新发传染病电子杂志》2023年第6期37-41,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020064);柳州市科技计划项目(2020NBAD0801)。

摘　　要：目的探讨多替拉韦钠(dolutegravir,DTG)+拉米夫定(lamivudine,3TC)简化方案在初治HIV感染/AIDS患者中的临床疗效。方法选取2019年1月至2022年9月期间在广西壮族自治区胸科医院接受抗反转录病毒治疗(antiretroviral therapy,ART)的初治HIV感染/AIDS患者,根据入组标准,观察组47例,采用DTG+3TC方案治疗;对照组49例,采用替诺福韦(tenofovir,TDF)+3TC+依非韦伦(efavirenz,EFV)方案治疗,观察比较两组治疗36周时HIV抑制率、免疫学情况。结果两组患者的基线特征中,年龄分布及基线HIV RNA载量差异具有统计学意义,其余基线指标未见明显差异;治疗12周,观察组及对照组病毒抑制率分别为56.6%、30.6%(P=0.011);治疗24周,两组病毒抑制率分别为63.6%、79.6%(P=0.139);治疗36周,两组病毒抑制率分别为85.1%和81.6%(P=0.786),中位CD4^(+)T淋巴细胞计数、CD4^(+)/CD8^(+)T淋巴细胞比值较于基线均明显升高,两组升高幅度无明显差异(P>0.05)。结论DTG+3TC两药简化方案在治疗初治HIV感染/AIDS患者的病毒抑制效果与TDF+3TC+EFV三联疗法并无差别,甚至早期病毒抑制率优于TDF+3TC+EFV三药方案,同时能有效改善免疫功能。Objective To investigate the clinical efficacy of a simplified regimen of dolutegravir(DTG)+lamivudine(3TC)in first-treatment human immunodeficiency virus infection/acquired immure deficiency syndrome patients.Method Historical control subgroups were selected,and primary HIV/AIDS patients who received antiretroviral therapy(ART)at the Chest Hospital of Guangxi Zhuang Autonomous Region between January 2019 and September 2022 were selected.According to the enrolment criteria,47 cases in the observation group were treated with DTG+3TC regimen,and 49 cases in the control group were treated with tenofovir(TDF)+lamivudine(3TC)+efavirenz(EFV)regimen,and the HIV suppression rate and immunological status of the two groups were compared with each other after 36 weeks of treatment under observation.Result In the baseline characteristics of the two groups,the difference in age distribution and baseline HIV RNA load capacity were statistically significant,with no significant difference in residual baseline index;at 12 week of treatment,the observation group and control group were 56.6%and 30.6%,respectively(P=0.011);at 24 weeks of treatment,the viral suppression rates of the two groups were 63.6%and 79.6%,respectively(P=0.139);at 36 weeks treatment,the viral suppression rates of the two groups were 85.1%and 81.6%,respectively(P=0.786),and the median CD4^(+)T lymphocyte counts and CD4^(+)/CD8^(+)T lymphocyte ratios were significantly higher than those at baseline,and there was no significant difference in the magnitude of the increase between the two groups(P>0.05).Conclusion The viral suppression effect of the simplified two-drug regimen of DTG+3TC in the treatment of first-treatment HIV/AIDS patients was not different from that of the triple-drug regimen of TDF+3TC+EFV,and even the early viral suppression rate was better than that of the triple-drug regimen of TDF+3TC+EFV,and at the same time it could effectively improve immune function.

关 键 词：艾滋病 拉米夫定 多替拉韦钠 两药方案 临床疗效 

分 类 号：R512.91[医药卫生—内科学]