依非韦伦减量后对艾滋病病毒感染者的临床疗效及安全性研究

Study on the Clinical Efficacy and Safety of Efavirenz Reduced Dose in HIV-Infected Patients

目的:探究艾滋病病毒感染者减量使用依非韦伦(EFV),联合富马酸替诺福韦二吡呋酯片(TDF)、拉米夫定(3TC)抗病毒治疗后的临床疗效及安全性研究。方法:自2022年01月~2023年09月我们招募重庆市铜梁区人民医院感染性疾病科门诊各28名艾滋病病毒感染者做为研究组和对照组,以上参与者均连续抗病毒治疗1年以上。按服用依非韦伦用量分组,2组均服用富马酸替诺福韦二吡呋酯片(TDF)、拉米夫定(3TC)的基础上联合使用EFV 400 mg为研究组,联合使用依EFV 600 mg为对照组。监测联合TDF、3TC的基础上使用不同剂量EFV 1年后艾滋病病毒感染者CD4、病毒载量的变化,及采用问卷调查的方式记录不良反应事件。结果:TDF、3TC联合使用EFV 400 mg和EFV 600 mg 1年后的研究组和对照组2组间以及组内比较,CD4细胞、病毒载量、淋巴细胞、肝功能差异无统计学意义(P > 0.05)。联合使用EFV 400 mg的研究组不良反应发生率显著低于EFV 600 mg组,差异有统计学意义(P < 0.05)。结论:艾滋病病毒感染者改用减量后的EFV 400 mg联合TDF、3TC抗病毒治疗后可保持有效的病毒抑制以及机体免疫功能的恢复,同时可减少不良反应事件的发生。

Background: Study on the clinical efficacy and safety of reduced dosage of Efavirenz (EFV) combined with tenofovir (TDF) and lamivudine (3TC) in HIV-infected patients. Method: From January 2022 to September 2023, we recruited 28 HIV-infected patients from the Infectious Diseases Department of Tongliang District People’s Hospital of Chongqing as the study group and the control group, and the above participants were treated with antiviral therapy for more than 1 year. The two groups were divided according to the dosage of efavirenz. On the basis of Tenofovir dipifurate fumarate tablet (TDF) and lamivudine (3TC), EFV 400 mg was used as the study group and EFV 600 mg was used as the control group. The changes of CD4 and viral load in HIV-infected patients after different doses of EFV1 were monitored on the basis of combined TDF and 3TC, and adverse events were recorded by questionnaire survey. Results: There was no significant difference in CD4 cells, viral load, lymphocyte and liver function between the two groups and the control group after 1 year of TDF and 3TC combined with EFV 400 mg and EFV 600 mg (P > 0.05). The incidence of adverse reactions in the combined EFV 400 mg group was significantly lower than that in EFV 600 mg group, and the difference was statistically significant (P < 0.05). Conclusion: The combination of EFV 400 mg with TDF and 3TC antiviral therapy can maintain effective viral inhibition and the recovery of immune function, However, patients receiving 400 mg EFV have reduced adverse events.