洛匹那韦/利托那韦在艾滋病成人经治病人中的临床应用进展

Lopinavir/ritonavir:a review of its use in the management of ART-experienced adult patients of HIV-1 infection

在设计良好的随机临床试验中,洛匹那韦/利托那韦(LPV/r)与其他抗反转录病毒治疗(ART)联合应用,使经治艾滋病病人获得持久的病毒学疗效,并且重建了宿主免疫功能,同时LPV/r对经治病人亦具有较高的耐药屏障。LPV/r·作为一个成熟的基准药物,常用于与其他蛋白酶抑制剂的非劣效性比较研究。但是考虑到LPV/r相关胃肠道不良反应和高甘油三酯血症及高胆固醇血症,当出现高脂血症时需要同时给予降脂药以降低冠心病的风险。此综述对成人Ⅰ型艾滋病病毒(HIV-1)感染经治病人,应用包含LPV/r抗病毒治疗方案的临床疗效、安全性及耐药研究进展进行较全面系统的总结。

The well designed and randomized clinical trials show that lopinavir and ritonavir （LPV/r） in combination with other antiretroviral therapies （ART） could provide durable virological suppression and reconstructe the host immune function in ART-experienced adult patients. Furthermore, lopinavir/ritonavir can demonstrate a high barrier to the development of resistance in ART-experienced patients. Lopinavir/ritonavir has served as a well established benchmark comparator for the noninferiority of other ritonavir-boosted PI regimens. Although being generally well tolerated, lopinavir/ritonavir is associated with generally manageable adverse gastrointestinal side effects and hypertriglyceridaemia and hypercholesterolaemia, which may require coadministration of tipidlowering agents to reduce the risk of coronary heart disease. This review summarizes the progress in the efficacy, safety, and drug resistance of adult patients with HIV-1 infection who have been treated with a kaletra contained antiviral treatment regi- men.