联合雷特格韦用于HIV-1初次治疗有效性和安全性的Meta分析

发布时间：2018-01-13 14:12

本文关键词：联合雷特格韦用于HIV-1初次治疗有效性和安全性的Meta分析　出处：《中华疾病控制杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的评价联合雷特格韦治疗方案用于人类免疫缺陷病毒-1(human immunodeficiency virus 1,HIV-1)初次抗病毒治疗的安全性和有效性。方法检索联合雷特格韦用于HIV-1感染者初次抗病毒治疗的临床随机对照试验(randomized controlled trial,RCT),采用Rev Man 5.2软件和Stata 12.0进行Meta分析。结果纳入17个RCT,Meta分析结果:以血浆病毒载量50拷贝/ml为治疗有效。在治疗48周及96周,试验组有效率分别为84.21%、87.30%,与对照组相比差异均无统计学意义(均有P0.05);治疗240周,试验组有效率高于对照组(70.2%和61.5%),合并效应量(RR=1.15,95%CI:1.03~1.28,P=0.010)。试验组与对照组在腹泻、恶心、头晕、头痛、失眠等常见不良反应差异均无统计学意义(均有P0.05);其中96周及144/156周时脂质代谢异常增高合并效应量RR(95%CI)分别为:低密度脂蛋白0.16(0.05~0.49)、0.20(0.08~0.48),甘油三酯0.12(0.02~0.59)、0.12(0.03~0.59),总胆固醇0.04(0.00~0.40)、0.04(0.00~0.34)。脂质代谢指标异常增高发生率,试验组均少于对照组,差异均有统计学意义(均有P0.05)。结论雷特格韦联合核苷类逆转录酶抑制剂、非核苷类逆转录酶抑制剂或蛋白酶抑制剂可以作为HIV-1/艾滋病初次抗病毒治疗的可选方案,与目前推荐的抗病毒治疗方案疗效相当,且安全性较好,其中脂质代谢异增高常明显减少,但受纳入研究对象的限制,需要更多研究进一步证验证。
[Abstract]:Objective to evaluate the efficacy of combined therapy with Retgvir in the treatment of human immunodeficiency virus (HIV-1) human immunodeficiency virus 1 (virus 1). Methods the efficacy and safety of primary antiviral therapy for HIV-1. Methods the clinical randomized controlled trial (RCTT) combined with Rategevel for the first time antiviral therapy in patients with HIV-1 was retrieved. Randomized controlled trial. Rev Man 5.2 software and Stata 12.0 were used for Meta analysis. The results were included in 17 RCT. Meta analysis showed that the plasma viral load of 50 copies / ml was effective. At 48 and 96 weeks of treatment, the effective rates of the test group were 84.21% and 87.30%, respectively. There was no significant difference between the control group and the control group (P 0.05). After 240 weeks of treatment, the effective rate in the trial group was higher than that in the control group (70.2% and 61.5%). There was no significant difference in common adverse reactions such as diarrhea, nausea, dizziness, headache and insomnia between the experimental group and the control group (P 0.05). In 96 weeks and 144/156 weeks, the combined effect of abnormal increase of lipid metabolism was 0.165U 0.49 (RRN 95CI), respectively. 0.20, 0.08, 0.48, triglyceride, 0.12, 0.02, 0.59, 0.12, 0.03, 0.59). The incidence of abnormal increase of lipid metabolism index in the trial group was lower than that in the control group. The difference was statistically significant (P 0.05). Conclusion Retergevir combined with nucleoside reverse transcriptase inhibitors. Non-nucleoside reverse transcriptase inhibitors or protease inhibitors can be used as the first anti-viral treatment of HIV-1 / AIDS, the efficacy is comparable to the current recommended anti-viral treatment, and the safety is good. The abnormal increase of lipid metabolism often decreased significantly, but limited by the subjects involved, more studies were needed to verify it.
【作者单位】：厦门大学公共卫生学院;分子疫苗学与分子诊断学国家重点实验室国家传染病诊断试剂与疫苗工程技术研究中心;厦门大学生命科学学院;兰州大学循证医学中心;山西医科大学公共卫生学院流行病学教研室;
【基金】：国家自然科学基金(81371818) 福建省科技创新平台(2014Y2004)
【分类号】：R512.91
【正文快照】： (Chin J Dis Control Prev 2017,21(5):504-509)【作者单位】1厦门大学公共卫生学院,福建厦门3611022分子疫苗学与分子诊断学国家重点实验室,国家传染病诊断试剂与疫苗工程技术研究中心,福建厦门3611023厦门大学生命科学学院,福建厦门3611024兰州大学循证医学中心,甘肃兰州730

【相似文献】