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含TDF的HAART方案对抗逆转录病毒药物初治成年HIV感染患者肾功能的影响研究 被引量:3

Effects of highly active antiretroviral therapy including tenofovir disoproxil fumarate on renal function among antiretroviral-nave HIV-infected adult patients
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摘要 目的探索含替诺福韦酯(tenofovir disoproxil fumarate,TDF)的高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)对抗逆转录病毒药物初治HIV感染患者肾功能的影响。方法本研究回顾性分析TDF治疗组和非TDF治疗组、依非韦伦(efavirenz,EFV)治疗组(即采用TDF+lamivudine(3TC)+EFV方案治疗)和克力芝(lopinavir/ritonavir,LPV/RTV)治疗组(即采用TDF+3TC+LPV/RTV方案治疗)在CD4细胞计数和内生肌酐清除率(rate of creatinine clearance,Cr Cl)上的差异。结果 TDF治疗组和非TDF治疗组患者的CD4细胞计数开始明显升高的时间分别为12周和48周。TDF治疗组患者在第24、48、60、72、84、96周时,Cr Cl比其基线时降低,差异具有统计学意义(均有P<0.05),而非TDF治疗组患者治疗后,Cr Cl未出现明显降低,无有统计学意义(均有P>0.05)。EFV治疗组和LPV/RTV治疗组患者均从第12周起,CD4细胞计数升高,差异均有统计学意义(均有P<0.05)。EFV治疗组患者和LPV/RTV治疗组患者的Cr Cl开始比其基线时降低的时间分别是72周和12周。结论在患者各项危险因素可控的情况下,推荐TDF+3TC+EFV为初治HIV患者的首选治疗方案。 Objective To explore the impact of tenofovir disoproxil fumarate( TDF) included in high active antiretroviral treatment( HAART) regimens on renal function and to compare the influence of two different TDF-containing HAART regimens. Methods A retrospective analysis was conducted to compare the CD4 cell count and rate of creatinine clearance( Cr Cl) between the TDF-treated group and non-TDF-treated group as well as the EFV-treated group( patients treated with TDF + lamivudine( 3TC) + efavirenz( EFV)) and LPV / RTV-treated group( patients treated with TDF +3TC + lopinavir / ritonavir( LPV / RTV)) at baseline,12 weeks,24 weeks,36 weeks,48 weeks,60 weeks,72 weeks,84 weeks and 96 weeks post treatment initiation. Results CD4 cell count of the TDF-treated group and non-TDF-treated group increased significantly since 12 weeks and 48 weeks posttreatment respectively; Cr Cl had a statistically significant decrease in the TDF-treated group( all P〈0. 05) but not in the non-TDF-treated group( all P〈0. 05) in the 24 weeks,48 weeks,60 weeks,72 weeks,84 weeks and 96 weeks. CD4 cell count in the EFV-treated group and the LPV / RTV-treated group had a statistically significant increase since 12 weeks after treatment( all P〈0. 05); Cr Cl in the EFV-treated group had a significant decline since 72 weeks while in the LPV / RTV-treated group,it declined since 12 weeks. Conclusions When the risk factors are under control,the TDF + 3TC + EFV regimen is recommend as the optimal therap.
出处 《中华疾病控制杂志》 CAS CSCD 北大核心 2015年第12期1211-1214,1281,共5页 Chinese Journal of Disease Control & Prevention
基金 "十二五"国家科技重大专项(2012ZX10001003-001)
关键词 抗逆转录病毒治疗 高效 获得性免疫缺陷综合征 流行病学研究 Antiretroviral therapy highly active Acquired immunodeficiency syndrome Epidemiologic studies
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  • 1Cooper DA. Life and death in the cART era [ J]. The Lancet, 2008,372 ( 9635 ) : 266-267.
  • 2Tanaka H, Arai M, Tomoda Y, et al. Evaluation of renal adverse effects of combination anti-retroviral therapy including tenofovir in HIV-infected patients [J]. J Pharm Pharm Sci, 2013,16 (3): 405-413.
  • 3Panel on antiretroviral guidelines for adults and adolescents. Guidelines for the use of antiretroviral agents in HIV-l-infected a- dults and adolescents [ EB/OL]. (2011-10-14) [ 2014-,05-30 ] http://www, aidsinfo, nih. gov/ContentFiles/AdultandAdolescent- GL. pdf.
  • 4Nelson MR, Katlama C, Montaner JS, et al. The safety of tenofo- vir disoproxil fumarate for the treatment of HIV infection in adults: the first 4 years [ J ]. AIDS, 2007,21 ( 10 ) : 1273-1281.
  • 5DW Cockcroft, MH Gauh. Prediction of creatinine clearance from serum creatinine [J]. Nephron, 1976,16( 1 ) :31-41.
  • 6Cao y, Han Y, Xie J, et al. Impact of a tenofovir disoproxil fuma- rate plus ritonavir-boosted protease inhibitor-based regimen on re- nal function in HlV-infected individuals: a prospective, multi- center study [ J ]. BMC Infect Dis, 2013,13:301.
  • 7Kinai E, Hanabusa H. Progressive renal tubular dysfunction asso- ciated with long-term use of tenofovir DF [ J]. AIDS Res Hum Retroviruses, 2009,25 ( 4 ) :387-394.
  • 8Rodrfguez-Nevoa S, Labarga P, D'Avolio A, et al. Impairment in kidney tubular function in patients receiving tenofovir is associated with higher tenofovir plasma concentrations [ J]. AIDS, 2010,24 (7) :1064-1066.
  • 9Nishijima T, Gatanaga H, Shimbo T, et al. Switching tenofovir! emtricitabine plus lopinavir/r to rahegravir plus Darunavir/r in pa- tients with suppressed viral load did not result in improvement of renal function but could sustain viral suppression: a randomized multicenter trial [J]. PLoS One, 2013,8(8) :e73639.
  • 10Kearney BP, Mathias A, Mittan A, et al. Pharmacokinetics and safety of tenofovir disoproxil fumarate on coadministration with lopi- navir/ritonavir [ J ]. J Acquit Immune Defic Syndr, 2006,43 ( 3 ) : 278-283.

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