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[1]孙建军,刘 莉,沈银忠,等.TDF+3TC+EFV 和AZT+3TC+EFV 方案治疗96 周对初治HIV 感染者肾功能的影响[J].传染病信息,2019,02:122-126.
 SUN Jian-jun,LIU Li,SHEN Yin-zhong,et al.Renal function of na?ve HIV patients after 96-week TDF+3TC+EFV or AZT+3TC+EFV treatment[J].Infectious Disease Information,2019,02:122-126.
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TDF+3TC+EFV 和AZT+3TC+EFV 方案治疗96 周对初治HIV 感染者肾功能的影响(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2019年02期
页码:
122-126
栏目:
论 著
出版日期:
2019-05-15

文章信息/Info

Title:
Renal function of na?ve HIV patients after 96-week TDF+3TC+EFV or AZT+3TC+EFV treatment
文章编号:
1007-8134(2019)02-0122-05
作者:
孙建军刘 莉沈银忠张仁芳官丽倩王江蓉齐唐凯王珍燕汤 阳宋 炜陈 军 卢洪洲
201508,上海市公共卫生临床中心感染与免疫科(孙建军、刘莉、沈银忠、张仁芳、官丽倩、王江蓉、齐唐凯、王珍燕、汤阳、宋炜、陈军、卢洪洲)
Author(s):
SUN Jian-jun LIU Li SHEN Yin-zhong ZHANG Ren-fang GUAN Li-qian WANG Jiang-rong QI Tang-kai WANG Zhen-yan TANG Yang SONG Wei CHEN Jun LU Hong-zhou*
SUN Jian-jun and LIU Li are the first authors who contributed equally to the article   Department of Infection and Immunization, Shanghai Public Health Clinical Center, 201508, China
关键词:
HIV 感染抗反转录病毒富马酸替诺福韦二吡呋酯齐多夫定肾小球滤过率
Keywords:
HIV infection antiretroviral therapy tenofovir disoproxil fumarate zidovudine glomerular filtration rate
分类号:
R512.91
DOI:
10.3969/j.issn.1007-8134.2019.02.006
文献标识码:
A
摘要:
目的 探讨应用我国首选抗HIV 治疗方案富马酸替诺福韦二吡呋酯(tenofovir disoproxil fumarate, TDF)+ 拉 米夫定(lamivudine, 3TC)+ 依非韦伦(efavirenz, EFV)及备选方案齐多夫定(zidovudine, AZT)+3TC+EFV 对初治HIV 感染者 肾功能的影响。方法 回顾性分析2012 年1 月—2014 年5 月在上海市公共卫生临床中心艾滋病门诊使用上述2 种方案抗病毒 治疗并随访的初治HIV 感染者1045 例,其中应用TDF+3TC+EFV 方案(TDF 组) 455 例,AZT+3TC+EFV 方案(AZT 组)590 例。 收集患者人口学资料及临床治疗数据,分析2 组治疗过程中肾功能指标变化情况。结果 TDF 组的基线、治疗48 周、96 周估 算肾小球滤过率(estimated glomerular fi ltration rate, eGFR)分别是113.1 ml/(min·1.73 m2),114.0 ml/(min·1.73 m2)和112.2 ml/ (min·1.73 m2);AZT 组的基线、治疗48 周、96 周eGFR 分别是112.9 ml/(min·1.73 m2),116.2 ml/(min·1.73 m2)和118.1 ml/ (min·1.73 m2)。与治疗前相比,TDF 组治疗48 周eGFR 水平有稍微升高,而在治疗96 周时又回落至基线水平。而AZT 组, 治疗48 周及96 周的eGFR 水平与基线eGFR 水平相比均有升高。TDF 组中基线eGFR < 90 ml/(min·1.73 m2)者, 治疗48 周eGFR 水平较基线有上升;AZT 组中基线eGFR < 90 ml/(min·1.73 m2)者治疗48 周eGFR 水平较基线有 所升高。结论 我国初治HIV 感染者中应用TDF+3TC+EFV 方案治疗者,开始治疗的2 年内患者肾功能无明显减低; 对于60 ml/(min·1.73 m2)< eGFR < 90 ml/(min·1.73 m2)的初治HIV 感染者,TDF 组治疗后eGFR 亦保持稳定。 关于TDF 组远期治疗后肾功能变化有待于进一步观察。 
Abstract:
Objective To investigate the effects of tenofovir disoproxil fumarate (TDF)+lamivudine (3TC)+efavirenz (EFV) and the optional treatment of zidovudine (AZT)+3TC+EFV on renal function of na?ve HIV-infected patients. Methods A retrospective study was conducted among 1045 na?ve HIV-infected patients, who were treated with TDF+3TC+EFV regimen or AZT+3TC+EFV regimen and followed up from January 2012 to May 2014 in Shanghai Public Health Clinic Center. Among the involved 1045 patients, 455 cases received TDF+3TC+EFV regimen (TDF group) and 590 cases received AZT+3TC+EFV regimen (AZT group). The demographic and clinical treatment data of all patients were collected, the changes of renal function index in 2 groups were analyzed. Results At baseline, 48-week and 96-week treatment, the eGFR of TDF group were 113.1 ml/(min·1.73 m2), 114.0 ml/(min·1.73 m2) and 112.2 ml/(min·1.73 m2), respectively. At baseline, 48-week and 96-week treatment, the eGFR of AZT group were 112.9 ml/ (min·1.73 m2), 116.2 ml/(min·1.73 m2) and 118.1 ml/(min·1.73 m2), respectively. Compared with baseline, the eGFR value of TDF group increased slightly at 48 weeks and fell back to the baseline level at 96 weeks. Compared with baseline, the eGFR value increased in AZT group at 48 and 96 weeks. For patients with baseline eGFR < 90 ml/(min·1.73 m2) in TDF group, the eGFR increased at 48 weeks compared with baseline; For patients with baseline eGFR < 90 ml/(min·1.73 m2) in AZT group, the eGFR increased at 48 weeks compared with baseline. Conclusions The regimen of TDF+3TC+EFV does not significantly reduce the renal function within the first two years of treatment among na?ve HIV-infected patients in China. For na?ve HIV-infected patients with 60 ml/(min·1.73 m2) < eGFR < 90 ml/(min·1.73 m2), TDF regimen maintains stable eGFR after treatment. The changes of renal function in TDF group after long-term treatment need to be further observed.

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备注/Memo

备注/Memo:
[ 基金项目] “十三五”国家重大新药创制专项(2017ZX09304027) 前两位作者对本文有同等贡献,均为第一作者
[ 通信作者] 卢洪洲,E-mail: luhongzhou@fudan.edu.cn
*Corresponding author, E-mail: luhongzhou@fudan.edu.cn
更新日期/Last Update: 2019-05-15