含TDF的HAART方案对抗逆转录病毒药物初治成年HIV感染患者肾功能的影响研究

发布时间：2018-04-28 21:40

本文选题：抗逆转录病毒治疗 + 高效　；参考：《中华疾病控制杂志》2015年12期

【摘要】：目的探索含替诺福韦酯(tenofovir disoproxil fumarate,TDF)的高效抗逆转录病毒疗法(highly active antiretroviral therapy,HAART)对抗逆转录病毒药物初治HIV感染患者肾功能的影响。方法本研究回顾性分析TDF治疗组和非TDF治疗组、依非韦伦(efavirenz,EFV)治疗组(即采用TDF+lamivudine(3TC)+EFV方案治疗)和克力芝(lopinavir/ritonavir,LPV/RTV)治疗组(即采用TDF+3TC+LPV/RTV方案治疗)在CD4细胞计数和内生肌酐清除率(rate of creatinine clearance,Cr Cl)上的差异。结果 TDF治疗组和非TDF治疗组患者的CD4细胞计数开始明显升高的时间分别为12周和48周。TDF治疗组患者在第24、48、60、72、84、96周时,Cr Cl比其基线时降低,差异具有统计学意义(均有P0.05),而非TDF治疗组患者治疗后,Cr Cl未出现明显降低,无有统计学意义(均有P0.05)。EFV治疗组和LPV/RTV治疗组患者均从第12周起,CD4细胞计数升高,差异均有统计学意义(均有P0.05)。EFV治疗组患者和LPV/RTV治疗组患者的Cr Cl开始比其基线时降低的时间分别是72周和12周。结论在患者各项危险因素可控的情况下,推荐TDF+3TC+EFV为初治HIV患者的首选治疗方案。
[Abstract]:Objective to investigate the effects of high active antiretroviral therapy with tenofovir disoproxil fumarate on renal function in patients with HIV infection. Methods the TDF treatment group and the non- treatment group were retrospectively analyzed in this study. The difference of CD4 cell count and creatinine clearance rate of creatinine clearance rate (Cr Cl) between the two groups (i.e., TDF lamivudine 3TC- EFV regimen) and lopinavirr / ritonavirr / ritonavirus-LPV-rRTV treatment group (i.e. TDF 3TC LPV/RTV regimen). Results the CD4 cell counts in the TDF treatment group and the non-TDF treatment group were significantly increased at 12 and 48 weeks, respectively. The CD4 cell counts in the TDF-treated group were significantly lower than those in the baseline group at the 24th week, 48th week, 6072U 84U, 96th week, respectively. The difference was statistically significant (P 0.05), but there was no significant decrease of Cr Cl in non-TDF treatment group (both P0.05).EFV treatment group and LPV/RTV treatment group increased CD4 cell count from the 12th week after treatment). There were significant differences between the two groups (the beginning time of the decrease of CRCL in P0.05).EFV group and LPV/RTV group was 72 weeks and 12 weeks, respectively). Conclusion under the condition of controllable risk factors, TDF 3TC EFV is recommended as the first choice of treatment for patients with HIV.
【作者单位】：德宏州人民医院感染科;芒市人民医院感染科;德宏州第二人民医院感染科;瑞丽市人民医院感染科;陇川县人民医院感染科;盈江县人民医院感染科;梁河县人民医院感染科;
【基金】：“十二五”国家科技重大专项(2012ZX10001003-001)
【分类号】：R512.91

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