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Very high baseline HIV viremia impairs efficacy of non-nucleoside reverse transcriptase inhibitor-based ART:a longterm observation in treatment-naïve patients

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Infectious Diseases of Poverty 2020年第3期9卷 144-145页

作者： Shuai Chen Yang Han Xiao-Jing Song Yan-ling Li Ting Zhu Hong-Zhou Lu Xiao-Ping Tang Tong Zhang Min Zhao Yun He Sheng-Hua He Min Wang Yong-Zhen Li Shao-Biao Huang Yong Li Jing Liu Wei Cao Tai-Sheng Li Department of Infectious Diseases Peking Union Medical College HospitalChinese Academy of Medical SciencesNo.1 ShuaifuyuanWangfujing StreetBeijing 100730China 不详

Background:It is not completely clear whether a very high pre-therapy viral load(≥500000 copies/ml)can impair the virological *** aim of this study was to examine the influence of very high baseline HIV-RNA levels on long-term virological responses under one type of ***:A retrospective study was performed based on data from two multicenter cohorts in China from January to November 2009,and from May 2013 to December *** HIV infected adults between 18 and 65 years old were recruited before receiving non-nucleoside reverse transcriptase inhibitor-based *** patients had baseline HIV-RNA levels over 500 copies/ml,good adherence,and were followed for at least 24 *** suppression was defined as the first HIV-RNAvirological suppression within 24 weeks of treatment)and viral rebound(confirmed HIV-RNA level≥50 copies/ml after virological suppression).Chi-square test,Kaplan–Meier analysis,Cox proportional hazards model and Logistic regression were used to compare virological response between each pretreated viral load ***:A total of 758 treatment-naïve HIV patients in China were *** follow-up time(IQR)was 144(108–276)*** week 48,rates of virological suppression in three groups(virological suppression(≥500000 vs<100000,adjusted relative hazard=0.455,95%CI:0.32–0.65;P<0.001)as well as incomplete viral suppression(≥500000 vs<100000,adjusted odds ratio[aOR]=6.084,95%CI:2.761–13.407;P<0.001)and viral rebound(≥50000 vs<100000,aOR=3.671,95%CI:1.009–13.355,P=0.048).Conclusions:Very high levels of pre-treatment HIV-RNA were related with delayed efficacy of NNRTI-based ART and increased risk of treatment failure.

关键词： HIV Viral load Baseline RNA Antiretroviral therapy Treatment outcome virologic response

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Efficacy and safety of tenofovir alafenamide in patients with chronic hepatitis B exhibiting suboptimal response to entecavir

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World Journal of Clinical Cases 2023年第34期11卷 8139-8146页

作者： Gui-Cai Yuan Ai-Zhen Chen Wei-Xin Wang Xu-Lan Yi Long Tu Fang Peng Zhi-Hong Qiu Department of Infectious Diseases Yichun University Second Affiliated HospitalYichun 336000Jiangxi ProvinceChina

BACKGROUND Entecavir(ETV)is a potent and safe antiviral agent for patients with chronic hepatitis B(CHB);however,some patients may exhibit suboptimal response or resistance to *** alafenamide(TAF)is a novel tenofovir prodrug with improved pharmacokinetics and reduced renal and bone toxicity compared with tenofovir disoproxil *** To evaluate the efficacy and safety of switching from ETV to TAF in patients with CHB exhibiting suboptimal response to *** A total of 60 patients with CHB who had been treated with ETV for at least 12 mo and had persistent or recurrent viremia[Hepatitis B virus(HBV)DNA≥20 IU/mL]or partial virologic response(HBV DNAvirologic response(HBV DNA levelvirologic response was significantly higher in the TAF group than in the ETV group(93.3%vs 66.7%,P=0.012).The mean reduction in HBV DNA from baseline was also significantly greater in the TAF group than in the ETV group(-3.8 vs-2.4 Log10 IU/mL,P<0.001).The rates of ALT normalization,HBeAg loss,HBeAg seroconversion,and HBsAg loss were not found to significantly differ between the two *** of the patients developed genotypic resistance to ETV or *** drugs were well tolerated,with no serious adverse events or discontinuations caused by adverse *** significant changes were observed in the estimated glomerular filtration rate,serum creatinine level,or urine protein-to-creatinine ratio in either *** TAF group had a significantly lower decrease in bone mine

关键词： Entecavir Tenofovir alafenamide Chronic hepatitis B virologic response Renal and bone toxicity Suboptimal response

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