Approaches to antiretroviral therapy in HIV-infected patients with low CD4 lymphocyte counts


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There are increasing numbers of patients with late-stage HIV infection in the Russian Federation. To choose optimal antiretroviral therapy regimens for patients with severe immunosuppression is a relevant problem. According the data obtained in the ECHO and THRIVE, ARTEMIS, CASTLE, SPRING-2 and other trials, the efficacy and/or safety of efavirenz are higher than those of rilpivirine, comparable with those of raltegravir and dolutegravir; darunavir and atazanavir are more effective than lopinavir, but dolutegravir is more effective than raltegravir (in numerical terms) in patients with low CD4 lymphocyte counts (less than 50 cells/µl or 200 cells/µl depending on a trial. To choose therapy for patients with late-stage HIV infection is an intricate problem and requires an individual approach that will take into account not only the efficiency of therapy, but also its possible side effects, as well as potential drug interactions for the treatment of opportunistic infections.

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V Shakhgildyan

M Yagodkin

参考

  1. Покровский В.И., Ладная Н.Н., Соколова Е.В., О.И. Тушина, Буравцова Е.В. ВИЧ-инфекция. Информационный бюллетень №39 Федерального научно-методического центра по профилактике и борьбе со СПИДом ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора, Москва, 2014, с.52 Доступно по: http://www.hivrussia.org/files/bul_39.pdf. Ссылка активна на 01.08.2015.
  2. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://www.aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Accessed August 1, 2015.
  3. European AIDS Clinical Society (EACS) Guidelines version 7.1, November 2014 available online at http://www.eacsociety.org/files/guidelines-7.1-english.pdf. Accessed August 1, 2015.
  4. Протоколы диспансерного наблюдения и лечения больных ВИЧ-инфекцией Национального общества инфекционистов. Доступно по: http://arvt.ru/sites/default/files/nnoi-2014-protocol-disp-nabl-HIV.pdf. Ссылка активна на 01.08.2015.
  5. Cohen CJ, Molina JM, Cassetti I, Chetchotisakd P, Lazzarin A, Orkin C, Rhame F, Stellbrink HJ, Li T, Crauwels H, Rimsky L, Vanveggel S, Williams P, Boven K; ECHO, THRIVE study groups. Week 96 efficacy and safety of rilpivirine in treatment-naive, HIV-1 patients in two Phase III randomized trials. AIDS. 2013;27(6):939-950. doi: 10.1097/qad.0b013e32835cee6e.
  6. Rockstroh JK, DeJesus E, Lennox JL, Yazdanpanah Y, Saag MS, Wan H, Rodgers AJ, Walker ML, Miller M, DiNubile MJ, Nguyen BY, Teppler H, Leavitt R, Sklar P; STARTMRK Investigators. Durable Efficacy and Safety of Raltegravir Versus Efavirenz When Combined With Tenofovir/Emtricitabine in Treatment-Naive HIV-1-Infected Patients: Final 5-Year Results From STARTMRK. Acquir Immune Defic Syndr. 2013;63(1):77-85. doi: 10.1097/qai.0b013e31828ace69.
  7. Ortiz R, Dejesus E, Khanlou H, Voronin E, van Lunzen J, Andrade-Villanueva J, Fourie J, De Meyer S, De Pauw M, Lefebvre E, Vangeneugden T, Spinosa-Guzman S. Efficacy and safety of once daily darunavir/r vs lopinavir/r in treatment naïve HIV-infected patients at week 48. AIDS. 2008;22:1389-1397. doi: 10.1097/qad.0b013e32830285fb.
  8. Mills AM, Nelson M, Jayaweera D, Ruxrungtham K, Cassetti I, Girard PM, Workman C, Dierynck I, Sekar V, Abeele CV, Lavreys L. Once-daily darunavir/ritonavir vs. lopinavir/ritonavirin treatment-naive, HIV-1-infected patients:96-week analysis. AIDS. 2009;23:1679-1688. doi: 10.1097/qad.0b013e32832d7350.
  9. Orkin C, DeJesus E, Khanlou H, Stoehr A, Supparatpinyo K, Lathouwers E, Lefebvre E, Opsomer M, Van de Casteele T, Tomaka F. Final 192-week efficacy and safety of once-daily darunavir/ritonavir compared with lopinavir/ritonavir in HIV-1-infected treatment-naïve patients in the ARTEMIS trial. HIV Med. 2013;14(1):49-59. doi: 10.1111/j.1468—1293.2012.01060.x.
  10. Molina JM, Andrade-Villanueva J, Echevarria J, Chetchotisakd P, Corral J, David N, Moyle G, Mancini M, Percival L, Yang R, Thiry A, McGrath D; CASTLE Study Team. Once-daily atazanavir/ritonavir versus twice-daily lopinavir/ritonavir, each in combination with tenofovir and emtricitabine, for management of antiretroviral-naïve HIV-1-infected patients: 48 week efficacy and safety results of the CASTLE study. Lancet. 2008;372(9639):646-655. doi: 10.1016/s0140-6736(08)61081-8.
  11. Molina JM, Andrade-Villanueva J, Echevarria J, Chetchotisakd P, Corral J, David N, Moyle G, Mancini M, Percival L, Yang R, Wirtz V, Lataillade M, Absalon J, McGrath D; CASTLE Study Team. Once-Daily Atazanavir/Ritonavir Compared With Twice-Daily Lopinavir/Ritonavir, Each in Combination With Tenofovir and Emtricitabine, for Management of Antiretroviral-Naïve HIV-1—Infected Patients: 96-Week Efficacy and Safety Results of the CASTLE Study. J Acquir Immune Defic Syndr. 2010;53(3):323-332. doi: 10.1097/qai.0b013e3181c990bf.
  12. Uy J, Yang R, Wirtz V, Sheppard L, Farajallah A, McGrath D. Treatment of advanced HIV disease in antiretroviral-naïve HIV-1-infected patients receiving once-daily atazanavir/ritonavir or twice-daily lopinavir/ritonavir, each in combination with tenofovir disoproxilfumarate and emtricitabine. AIDS Care. 2011;23(11):1500-1504. doi: 10.1080/09540121.2011.565033.
  13. Walmsley SL, Antela A, Clumeck N, Duiculescu D, Eberhard A, Gutiérrez F, Hocqueloux L, Maggiolo F, Sandkovsky U, Granier C, Pappa K, Wynne B, Min S, Nichols G; SINGLE Investigators. Dolutegravir plus Abacavir-Lamivudine for the Treatment of HIV-1 Infection. N Engl J Med. 2013;369(19):1807-1818. doi: 10.1056/nejmoa1215541.
  14. Raffi F, Rachlis A, Stellbrink HJ, Hardy WD, Torti C, Orkin C, Bloch M, Podzamczer D, Pokrovsky V, Pulido F, Almond S, Margolis D, Brennan C, Min S; SPRING-2 Study Group. Once-daily dolutegravir versus raltegravir in antiretroviral-naïve adults with HIV-1 infection: 48 week results from the randomised, double-blind, non-inferiority SPRING-2 study. Lancet. 2013;381(9868):735-743. doi: 10.1016/s0140-6736(12)61853-4.

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