依非韦伦400 mg剂量进行艾滋病抗病毒治疗的研究进展

Overview on current development of the Dose of Efavirenz(400 mg)in treating HIV

EFV是我国艾滋病抗病毒治疗的首选一线药物,临床上常与替诺福韦、拉米夫定联合使用,国内EFV临床常用剂量为600 mg/d,EFV具有很好的抗HIV作用,由于EFV严重的中枢神经系统毒性,国内外对更低剂量的EFV进行了大量的对比研究,WHO及美国抗艾滋病指南已将EFV作为备选一线药物,且推荐了EFV 400 mg的使用方案。本文从国内外EFV使用历史、EFV剂量调整原因、血药浓度、药效、与CYP450同工酶药物联用、不良反应、基因敏感性多态性方面,阐述EFV 400 mg剂量保持疗效和降低不良反应的依据,从而为我国进行EFV剂量调整提供参考。

Efavirenz(EFV)is one of the first-line drugs against HIV in China.It is often used in combination with tenofovir and lamivudine.The commonly used dose of EFV is 600 mg per day in China with a satisfactory efficacy.Due to the severe central nervous system toxicity of EFV,a large number of comparative studies in China and worldwide were conducted to explore a lower dose of EFV.Currently,the WHO and US HIV guidelines have recommended a lower dose of EFV(400 mg per day)as an alternative HIV treatment first-line agent option.This article summarized the current evidence of clinical use of the lower dose of EFV,including reasons for EFV dosage adjustment,blood concentration,efficacy,combination with CYP450 isoenzymes drugs,adverse reactions,and genetic sensibility of individuals to the lower dose of EFV.This review aimed to provide a reference for EFV dose adjustment in China.