依非韦伦减量方案对抗病毒治疗疗效及美沙酮服用剂量影响的研究

Study on the efficacy of reduced dose regimen of Efevren(EFV)in antiviral therapy and the influence of methadone dosage

目的通过对同时服用400 mg/d EFV和美沙酮的患者免疫学、病毒学疗效以及美沙酮剂量的变化情况进行观察,为减量EFV的使用提供临床依据。方法对已接受ART(含EFV方案)的HIV感染者,调整其EFV的服用剂量为400 mg/d,观察开始前(基线)、减量后的第4周和第12周病毒载量、T淋巴细胞、美沙酮服用剂量、汉密尔顿抑郁量表的变化情况。结果12周内,34名研究对象的T淋巴细胞、HIV病毒载量的检测结果,差异无统计学意义(P>0.05)。美沙酮平均服用剂量由(111.77±47.14)mL/d下降到(74.84±42.75)mL/d。汉密尔顿抑郁量表的评估结果显示差异有统计学意义(t=8.786,P<0.001)。结论对于需要服用美沙酮的HIV/AIDS患者,减少EFV的每日服用剂量后,在不影响ART疗效的情况下,可以减轻对美沙酮的依赖。

Objective the purpose of this study is to provide a clinical basis for reducing the use of EFV by observing the immunological and virological effects of 400 mg/D EFV and methadone in patients.Methods the dosage of EFV was adjusted to 400 mg/D in HIV-infected patients who had received ART(including EFV regimen).The changes of viral load,lymphoid T cells,methadone dosage,and Hamilton Depression Scale were observed before the start of ART(baseline),four weeks,and 12 weeks after the reduction.Results Within 12 weeks,there was no significant difference in the detection results of clinical monitoring indicators of lymphoid T cells and HIV viral load of 34 subjects(P>0.05).The mean dose of methadone was(mean ±Standard deviation)111.77±47.14 ml/D to 74.84±42.75 ml/d.The results of Hamilton Depression Scale showed statistical difference(t=8.786,P<0.001).Conclusion for HIV/AIDS patients who need to take methadone,reducing the daily dose of EFV can reduce the dependence on methadone without affecting the efficacy of ART.