HIV阳性实体器官移植受者的免疫抑制药物管理  

Management of immunosuppressive drugs in HIV-positive solid organ transplant recipients

作　　者：邵琨[1,2] 王祥慧[1,2] 周佩军[1,2] Shao Kun;Wang Xianghui;Zhou Peijun(Depatrment of Urology,Shanghai Jiao Tong University School of Medicine Affiliated Ruijin Hospital,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿科,上海200025 [2]上海交通大学医学院附属瑞金海南医院国际移植医疗康复诊疗中心

出　　处：《器官移植》2024年第4期570-574,共5页Organ Transplantation

基　　金：海南省卫生健康行业科研项目(22A200345)。

摘　　要：联合抗逆转录病毒治疗(cART)的应用显著提高了人类免疫缺陷病毒(HIV)感染者的预期寿命。但病毒感染和cART药物的不良反应使患者更容易发生器官衰竭。针对HIV感染者的终末期器官衰竭患者,实体器官移植成为一种标准的治疗方案。然而,在HIV阳性实体器官移植受者中,存在移植物排斥反应发生增多、感染风险升高、药物毒性以及cART治疗和免疫抑制药之间的药物相互作用等诸多问题,管理HIV阳性实体器官移植受者具有极大的挑战性。因此,本文就免疫诱导治疗、钙调磷酸酶抑制剂、哺乳动物雷帕霉素靶蛋白抑制剂及其他免疫抑制药在HIV阳性实体器官移植受者中的应用进行综述,旨在为未来HIV阳性实体器官移植受者的免疫抑制管理提供参考。The application of combination antiretroviral therapy(cART)has significantly prolonged the life expectancy of patients infected with human immunodeficiency virus(HIV).However,viral infection and adverse reactions of cART drugs make patients more prone to organ failure.Solid organ transplantation has become a standard treatment for HIV-infected patients with end-stage organ failure.Nevertheless,among HIV-positive soild organ transplant recipients,multiple problems remain to be resolved,such as increased incidence of graft rejection,increased infection risk,drug toxicity and drug interaction between cART therapy and immunosuppressive drugs,etc.It is extremely challenging to deliver appropriate management for HIV-positive soild organ transplant recipients.Therefore,the application of immune induction therapy,calcineurin inhibitors,mammalian target of rapamycin(mTOR)inhibitors and other immunosuppressive drugs in HIV-positive soild organ transplant recipients was reviewed,aiming to provide reference for subsequent management of immunosuppression in HIV-positive soild organ transplant recipients.

关 键 词：人类免疫缺陷病毒 实体器官移植 联合抗逆转录病毒治疗 免疫诱导 钙调磷酸酶抑制剂 哺乳动物雷帕霉素靶蛋白抑制剂 霉酚酸 糖皮质激素 

分 类 号：R617[医药卫生—外科学] R373[医药卫生—临床医学]