含多替拉韦与含依非韦伦方案抗逆转录治疗对人类免疫缺陷病毒感染母婴影响的荟萃分析  

Meta-Analysis on Effects of Antiretroviral Therapy with Dolutegravir Versus Efavirenz Regimens on Human Immunodeficiency Virus Infection in Mothers and Infants

作　　者：刘志威 楚志文 黎运呈 陈友鹏 Liu Zhiwei;Chu Zhiwen;Li Yuncheng;Chen Youpeng(Huiyang Hospital Affiliated to Southern Medical University,Guangdong Huizhou 516200,China;The Seventh Affiliated Hospital,Sun Yat-sen University,Guangdong Shenzhen 518107,China)

机构地区：[1]南方医科大学附属惠阳医院,广东惠州516200 [2]中山大学附属第七医院,广东深圳518107

出　　处：《儿科药学杂志》2024年第7期45-49,共5页Journal of Pediatric Pharmacy

摘　　要：目的:分析含多替拉韦方案对比含依非韦伦方案抗逆转录治疗对人类免疫缺陷病毒(HIV)感染母婴影响情况。方法:检索建库至2023年6月在PubMed、EMBase、the Cochrane Library、Medline、中国知网、万方、维普、中国生物医学文献数据库公开发表的中英文研究,采用纽卡斯尔-渥太华量表(NOS)评分方法,纳入符合条件的文献,提取相关数据资料,利用RevMan 5.4软件进行荟萃分析。结果:最终共纳入文献6篇,其中多替拉韦组2769例患者,依非韦伦组6006例患者。两组孕产妇抗逆转录治疗后病毒应答率比较差异有统计学意义(RR=1.25,95%CI 1.06~1.46,Z=2.73,P<0.05)。胎儿及新生儿情况分析中,两组新生儿出生体质量比较差异有统计学意义(MD=0.14,95%CI 0.05~0.22,Z=3.03,P<0.05),而在胎儿及新生儿严重不良事件胎儿宫内死亡(OR=1.08,95%CI 0.78~1.49,Z=0.47,P>0.05)、早产(RR=0.95,95%CI 0.85~1.07,Z=0.82,P>0.05)、新生儿死亡(OR=0.71,95%CI 0.25~2.00,Z=0.65,P>0.05)比较差异无统计学意义。结论:孕期使用含多替拉韦抗逆转录治疗方案的病毒应答率高于含依非韦伦治疗组,同时依非韦伦治疗组新生儿体质量低于含多替拉韦组。Objective:To analyze the effects of antiretroviral therapy with dolutegravir versus efavirenz regimens on human immunodeficiency virus(HIV)infection in mothers and infants.Methods:Chinese and English studies published in PubMed,EMBase,the Cochrane Library,Medline,CNKI,Wanfang,VIP and CBM from the establishment of the database to Jun.2023 were retrieved.The Newcastle-Ottawa Scale(NOS)scoring method was used to extract the eligible literature and relevant data.RevMan 5.4 software was used for Meta-analysis.Results:A total of 6 literature were enrolled,including 2,769 patients in the dolutegravir group and 6,006 patients in the efavirenz group.There was statistically significant difference in viral response rate between two group of pregnant women after antiretroviral therapy(RR=1.25,95%CI from 1.06 to 1.46,Z=2.73,P<0.05).In the analysis of fetal and neonatal conditions,the difference in neonatal birth weight between two groups was statistically significant(MD=0.14,95%CI from 0.05 to 0.22,Z=3.03,P<0.05),while there was no significant difference between two groups in fetal and neonatal severe adverse events such as fetal intrauterine death(OR=1.08,95%CI from 0.78 to 1.49,Z=0.47,P>0.05),premature delivery(RR=0.95,95%CI from 0.85 to 1.07,Z=0.82,P>0.05)and neonatal death(OR=0.71,95%CI from 0.25 to 2.00,Z=0.65,P>0.05).Conclusion:The viral response rate of the antiretroviral therapy with dolutegravir during pregnancy is higher than that of antiretroviral therapy with efavirenz,and the neonatal body weight of the efavirenz group is lower than that of dolutegravir group.

关 键 词：多替拉韦 依非韦伦 人类免疫缺陷病毒 母婴 

分 类 号：R512.91[医药卫生—内科学]