o Bernardo do Campo县40例既往抗病毒药物耐药、恩福韦肽抗逆转录病毒治疗失败的HIV患者报告

Iara Cruz, J. Frazão, A. Condino-Neto, P. Errante
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摘要

人类免疫缺陷病毒(HIV)感染导致T CD4+细胞耗竭并伴有进行性免疫功能障碍,尽管抗逆转录病毒治疗有好处,但如果不明智地使用,它会导致耐药性的出现。在这项研究中,我们评估了40名在巴西圣保罗圣贝尔纳多坎波医学专科诊所注册的独特卫生系统- sus和药房的艾滋病毒患者。入组患者在HIV治疗失败后使用逆转录酶抑制剂(NRTIs)、非核苷类逆转录酶抑制剂(TTRNN)和蛋白酶抑制剂(PI)进行恩福韦肽治疗。通过病毒RNA定量、T CD4+细胞计数及患者临床表现评价恩孚韦肽治疗的有效性。我们的研究结果显示,所有患者在治疗后都出现了病毒载量的下降,在恩孚韦肽治疗期间出现的下降发生在治疗的前6个月。所有患者报告对恩孚韦肽治疗满意,但由于皮肤体征和消化症状等不良反应,在前一周观察到一次和不止一次停止恩孚韦肽治疗,提示在这种情况下,存在有利于耐药发展的情况。DOI: http://dx.doi.org/10.17525/vrr.v17i1 - 2.58
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A case report of 40 patients with HIV in São Bernardo do Campo with previous antiviral drug resistance, enfuvirtide antiretroviral treatment and treatment failure
Human immunodeficiency virus (HIV) infection leads to T CD4+ cell depletion with progressive immune dysfunction, and despite benefits of antiretroviral therapy, if not judiciously used, it leads to the emergence of drug resistance. In this study, we evaluated 40 patients with HIV that enrolled the Unique Health System-SUS and pharmacy of Medical Specialties Clinic of Sao Bernardo do Campo, Sao Paulo, Brazil. The enrolled patients were treated with enfuvirtide after treatment failure for HIV by the use of reverse transcriptase inhibitors (NRTIs), non-nucleoside inhibitors of transcriptase reverse (TTRNN) and protease inhibitors (PI). The effectiveness of enfuvirtide treatment was evaluated through viral RNA quantification, T CD4+ cell count and patient’s clinical manifestations. Our results show that all patients presented viral load reduction after treatment and the reduction seen during enfuvirtide treatment occurred under the first 6 months of treatment. All patients reported to be satisfied with enfuvirtide therapy, however discontinuation of enfuvirtide treatment once and more than once in the previous week was observed due to adverse reactions involving cutaneous signs and digestive symptoms, suggesting, in this case, the presence of a favorable situation towards the development of drug resistance. DOI:  http://dx.doi.org/10.17525/vrr.v17i1-2.58
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