摘要
目的探讨依非韦伦(efavirenz,EFV)转换为利匹韦林(rilpivirine,RPV)的抗病毒治疗方案对成人人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者(简称“HIV/AIDS患者”)血脂的影响。方法回顾性分析2019年3月至2021年9月首都医科大学附属北京佑安医院由EFV转换为RPV的67例HIV/AIDS患者的临床资料,比较RPV转换前后HIV病毒载量、CD4细胞数、血脂及肝肾功能情况。结果转换后,三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)及高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平下降,差异均有统计学意义(P<0.05);低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)水平虽有所下降,但差异无统计学意义(P>0.05)。转换后,血脂总异常率升高,TC及LDL-C异常率降低,但差异无统计学意义(P>0.05);TG异常率由52.24%降至32.84%,HDL-C异常率则由31.34%升至68.66%,差异有统计学意义(P<0.05)。转换后方案中不含替诺福韦是LDL-C水平升高的危险因素。转换后,患者的谷丙转氨酶、谷草转氨酶及肌酐均较前下降,差异有统计学意义(P<0.05)。结论RPV可显著降低TG和TC水平,但同时降低HDL-C水平,其在血脂方面的获益仍需更多研究。
Objective To investigate the effect of conversion of efavirenz(EFV)to rilpivirine(RPV)on blood lipids in adult human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients.Methods The clinical data of 67 patients with HIV/AIDS who were converted from EFV to RPV in Beijing Youan hospital,capital medical university,from March 2019 to September 2021 were retrospectively analyzed.The HIV viral load,CD4 cell count,blood lipid,liver and kidney function before and after RPV conversion were compared.Results After the conversion,the levels of triglycerides(TG),total cholesterol(TC)and high density lipoprotein-cholesterol(HDL-C)decreased,and the differences were statistically significant(P<0.05).The level of low density lipoprotein-cholesterol(LDL-C)decreased,but the difference was not statistically significant(P>0.05).After the conversion,the total abnormal rate of total blood lipid was increased,and the abnormal rates of TC and LDL-C decreased,but the differences were not statistically significant(P>0.05).The abnormal rate of TG decreased from 52.24%to 32.84%,and the abnormal rate of HDL-C increased from 31.34%to 68.66%,the differences were statistically significant(P<0.05).The absence of tenofovir in regimens was a risk factor for elevated LDL-C.After conversion,the levels of alanine aminotransferase,glutamine aminotransferase and creatinine decreased,and the differences were statistically significant(P<0.05).Conclusions RPV can significantly reduce TG and TC,but also reduce the level of HDL-C.Its benefit in blood lipid still needs more research.
作者
张长平
朱晓虹
刘炜
ZHANG Changping;ZHU Xiaohong;LIU Wei(Department of Pharmacy,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)
出处
《世界临床药物》
CAS
2022年第6期730-735,共6页
World Clinical Drug
基金
首都医科大学附属北京佑安医院中青年人才孵育项目(BJYAYY-GL2019-01)。
关键词
依非韦伦
利匹韦林
血脂
艾滋病
efavirenz
rilpivirine
blood lipid
acquired immunodeficiency syndrome
