50岁以上病毒学抑制的HIV-1感染者转用多鲁特韦/拉米夫定的实际有效性和安全性。

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2024-09-06 DOI:10.1111/hiv.13699
C Piñeiro, S Policarpo, C Caldas, L Santos, I Augusto, V P DiMondi, R Serrão
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引用次数: 0

摘要

目标:随着年龄的增长,艾滋病病毒感染者面临着一些挑战,其中包括可能会使用多种药物以及更容易受到与药物相关的不良反应的影响。因此,有效且耐受性良好、药物相互作用极小或没有的治疗方案对这一人群非常有用。我们介绍了年龄大于 50 岁、达到病毒学抑制(HIV-1 RNA 方法)的患者的真实有效性和安全性数据:这项在葡萄牙进行的回顾性、观察性、单中心研究纳入了年龄大于 50 岁、在病毒学抑制期间转用 DTG/3TC 且随访时间≥12 个月的患者。维持病毒学抑制的人数比例在 12 个月时进行了描述;CD4+ 细胞计数在基线和 12 个月时进行了描述。根据年龄、出生时的性别以及历史基因型耐药性结果进行了描述性亚组分析:共纳入了 538 名年龄大于 50 岁的患者(74% 为男性;平均年龄 62 岁;既往接受治疗的平均时间为 160 个月)。改用 DTG/3TC 治疗的患者在 12 个月的随访中保持病毒抑制的比例很高(意向治疗人群,97%;治疗人群,98%)。CD4+ 细胞计数保持稳定(平均基线:727 cells/mm3 [range 94-2371];平均第 12 个月:742 cells/mm3 [range 99-2659])。没有人出现病毒学失败。有 9 人(2%)因与治疗无关的原因中断了 DTG/3TC。按年龄、出生时性别和历史基因型耐药性结果划分的治疗亚组中,第 12 个月时病毒学抑制的比例相似:在葡萄牙,DTG/3TC 在年龄大于 50 岁的病毒学抑制患者中显示出强大的有效性和良好的安全性。
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Real-world effectiveness and safety of switching to dolutegravir/lamivudine among people living with HIV-1 aged over 50 years who are virologically suppressed.

Objectives: People living with HIV face several challenges as they age, including the potential for polypharmacy and increased susceptibility to drug-related adverse effects. Thus, effective and well-tolerated regimens with minimal or no drug interactions would be useful in this population. We present real-world effectiveness and safety data for individuals aged >50 years who achieved virological suppression (HIV-1 RNA <50 copies/mL) and switched to dolutegravir/lamivudine (DTG/3TC).

Methods: This retrospective, observational, single-centre study conducted in Portugal included individuals aged >50 years who switched to DTG/3TC while virologically suppressed and had ≥12 months of follow-up. Proportions of individuals maintaining virological suppression were described at 12 months; CD4+ cell counts were described at baseline and 12 months. Descriptive subgroup analyses were performed based on age, sex assigned at birth, and availability of historical genotypic resistance results.

Results: Overall, 538 individuals aged >50 years were included (74% male; mean age, 62 years; mean time on previous therapy, 160 months). High proportions (intention-to-treat population, 97%; on-treatment population, 98%) of individuals who switched to DTG/3TC maintained virological suppression through 12 months of follow-up. CD4+ cell counts remained stable (mean baseline: 727 cells/mm3 [range 94-2371]; mean month 12: 742 cells/mm3 [range 99-2659]). No individuals experienced virological failure. Nine (2%) individuals discontinued DTG/3TC for non-treatment-related reasons. Proportions with virological suppression at month 12 were similar between on-treatment subgroups by age, sex assigned at birth, and historical genotypic resistance results availability.

Conclusions: DTG/3TC demonstrated robust effectiveness and a good safety profile in individuals aged >50 years with virological suppression in Portugal.

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来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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