In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intole...In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intolerance to first-line efavirenz-based regimens.Given the considerable pill burden and adverse effects associated with LPV/r,treatment optimization is important for this population.This multicenter retrospective study aimed to evaluate the efficacy and safety of switching from LPV/r-based regimens to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF).Virological suppression rates(HIV-RNA<40 copies/mL)were primarily compared between the 48-week periods before and after switching to BIC/FTC/TAF.CD4 counts and metabolic data were also assessed.A total of 461 PLWH were recruited between January 2021 and December 2023,with 92.2% being male,a median age of 38 years,and a median antiretroviral therapy duration of 8 years.Prior to initiating LPV/r,23.0%(106/461)had documented virological failure.During LPV/r treatment,18.9%(20/106)of these individuals experienced viral rebound.Among all participants,the overall virological suppression rates significantly increased from 94.6%(pre-switch)to 98.6%(post-switch)(P<0.001).Notably,among participants with prior virological failure,suppression rates improved significantly from 81.1%to 97.2%(P<0.001),whereas no significant difference was observed in those without such history(from 98.6% to 99.2%,P=0.764).The median triglyceride level decreased from 2.4 mmol/L to 1.8 mmol/L(P<0.001),while no difference in CD4 counts was observed.These findings demonstrate that BIC/FTC/TAF is an effective and metabolically favorable treatment option for PLWH switching from LPV/r based regimens,regardless of whether they have a prior history of virological failure.展开更多
Background:Antiretroviral therapy(ART)was often associated with dyslipidemia among human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients.This study aimed to assess treatment-naïve adu...Background:Antiretroviral therapy(ART)was often associated with dyslipidemia among human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients.This study aimed to assess treatment-naïve adult male patients with HIV/AIDS who initiated ART with either co-formulated bictegravir,emtricitabine,and tenofovir alafenamide(BIC/FTC/TAF)or lamivudine,efavirenz,and tenofovir disoproxil fumarate(3TC+EFV+TDF),monitoring at weeks 4,12,24,and 48.Methods:A case-control retrospective study was conducted.The newly diagnosed HIV-infected individuals attending the sexual transmission disease(STD)/AIDS clinic of Beijing Youan Hospital,Capital Medical University,from January to December 2021.The patients were divided into BIC/FTC/TAF group or 3TC+EFV+TDF group.High-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),and total cholesterol(TC)at different time points over 48 weeks between two groups were compared.A multivariate Cox regression model was used to identify relevant influencing factors for the population at high risk of increased LDL-C.Results:A total of 870 participants,with 510 in BIC/FTC/TAF group and 360 in 3TC+EFV+TDF group.There were no statistically significant differences in median age,baseline CD4/CD8 ratio,median body mass index(BMI)between the two groups.In both two groups,levels of TG,TC,and LDL-C were higher at 4 weeks,12 weeks,and 24 weeks of treatment(all P<0.05),and there were no statistically significant differences at 48 weeks compared to those at baseline(all P>0.05).In addition,the differences in average changes of the level of TG,TC,HDL-C,and LDL-C from weeks 4,12,24,and 48 to baseline between two groups were not statistically significant(all P>0.05).Multivariate Cox proportional risk model analysis showed that initiating ART with HIV RNA≥10^(5)copies/mL(compared with<10^(5)copies/mL)was associated with an increased risk of elevated LDL-C(hazard ratio=1.26,95%confidence interval:1.07-1.48,P=0.005).Conclusions:Transient elevations in blood lipid levels(TC,TG,HDL-C,and LDL-C)were observed in treatment-naïve adult male HIV/AIDS patients with BIC/FTC/TAF at 4 weeks,12 weeks,and 24 weeks of treatment.However,these levels did not differ significantly from baseline after 48 weeks of treatment,regardless of whether patients were in the BIC/FTC/TAF or 3TC+EFV+TDF group.展开更多
Introduction:Human Immunodeficiency Virus(HIV)nonoccupational post-exposure prophylaxis(nPEP)clinics are specialized healthcare facilities that provide urgent medical interventions to individuals with potential high-r...Introduction:Human Immunodeficiency Virus(HIV)nonoccupational post-exposure prophylaxis(nPEP)clinics are specialized healthcare facilities that provide urgent medical interventions to individuals with potential high-risk HIV exposures.This study analyzed utilization patterns of HIV nPEP services in China and examined factors associated with medication adherence among consultees,providing evidence to inform further implementation and optimization of HIV nPEP interventions.Methods:We analyzed nPEP case data collected from the national nPEP data information system between November 1,2022,and November 1,2024,using SPSS 29.0 software.Chi-square tests were applied to analyze characteristics of nPEP consultees,and logistic regression models were used to identify factors influencing medication adherence and followup compliance among those who initiated treatment.Results:As of November 1,2024,924 nPEP clinics nationwide received 54,108 consultees,with 53,405(98.70%)initiating medication.Most individuals seeking services were male(88.63%),classified as high-risk(83.11%),and heterosexual with multiple partners(67.66%).The“BIC/FTC/TAF”regimen was selected by 63.07%of recipients.Nearly all users(99.03%)completed medication evaluation within 72 hours post-exposure.Among medication users,60.34%(30,650)adhered to the full 28-day regimen,and 60.10%(30,509)completed either onemonth or three-month follow-ups.Multivariate logistic regression analysis identified gender,exposure risk assessment results,exposure population classification,individual preferences,and medication regimen as significant factors influencing both 28-day medication adherence and follow-up compliance(P<0.05).Conclusions:nPEP clinic consultees in China are predominantly young male heterosexual individuals with multiple sexual partners,with most selecting the Biktarvy regimen.However,both current 28-day medication adherence and follow-up compliance rates remain suboptimal.High-risk men and those receiving the Biktarvy regimen demonstrate superior medication adherence and follow-up compliance compared to other groups.Further research is needed to develop targeted interventions to improve medication adherence and follow-up rates among nPEP recipients.Enhancing adherence and follow-up should be prioritized in future interventions,supported by continuous monitoring to inform timely intervention strategy adjustments.展开更多
基金supported by the Capital's Funds for Health Improvement and Research(CFH2024-2-2175).
文摘In China,approximately 13% of people living with human immunodeficiency virus(HIV)(PLWH)are receiving lopinavir/ritonavir(LPV/r)-based regimens.These PLWH typically have a history of either treatment failure or intolerance to first-line efavirenz-based regimens.Given the considerable pill burden and adverse effects associated with LPV/r,treatment optimization is important for this population.This multicenter retrospective study aimed to evaluate the efficacy and safety of switching from LPV/r-based regimens to the single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF).Virological suppression rates(HIV-RNA<40 copies/mL)were primarily compared between the 48-week periods before and after switching to BIC/FTC/TAF.CD4 counts and metabolic data were also assessed.A total of 461 PLWH were recruited between January 2021 and December 2023,with 92.2% being male,a median age of 38 years,and a median antiretroviral therapy duration of 8 years.Prior to initiating LPV/r,23.0%(106/461)had documented virological failure.During LPV/r treatment,18.9%(20/106)of these individuals experienced viral rebound.Among all participants,the overall virological suppression rates significantly increased from 94.6%(pre-switch)to 98.6%(post-switch)(P<0.001).Notably,among participants with prior virological failure,suppression rates improved significantly from 81.1%to 97.2%(P<0.001),whereas no significant difference was observed in those without such history(from 98.6% to 99.2%,P=0.764).The median triglyceride level decreased from 2.4 mmol/L to 1.8 mmol/L(P<0.001),while no difference in CD4 counts was observed.These findings demonstrate that BIC/FTC/TAF is an effective and metabolically favorable treatment option for PLWH switching from LPV/r based regimens,regardless of whether they have a prior history of virological failure.
基金supported by the Gilead Sciences and the Capital Health Research and Development of Special Fund(No.2022-1G-3015)
文摘Background:Antiretroviral therapy(ART)was often associated with dyslipidemia among human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients.This study aimed to assess treatment-naïve adult male patients with HIV/AIDS who initiated ART with either co-formulated bictegravir,emtricitabine,and tenofovir alafenamide(BIC/FTC/TAF)or lamivudine,efavirenz,and tenofovir disoproxil fumarate(3TC+EFV+TDF),monitoring at weeks 4,12,24,and 48.Methods:A case-control retrospective study was conducted.The newly diagnosed HIV-infected individuals attending the sexual transmission disease(STD)/AIDS clinic of Beijing Youan Hospital,Capital Medical University,from January to December 2021.The patients were divided into BIC/FTC/TAF group or 3TC+EFV+TDF group.High-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),and total cholesterol(TC)at different time points over 48 weeks between two groups were compared.A multivariate Cox regression model was used to identify relevant influencing factors for the population at high risk of increased LDL-C.Results:A total of 870 participants,with 510 in BIC/FTC/TAF group and 360 in 3TC+EFV+TDF group.There were no statistically significant differences in median age,baseline CD4/CD8 ratio,median body mass index(BMI)between the two groups.In both two groups,levels of TG,TC,and LDL-C were higher at 4 weeks,12 weeks,and 24 weeks of treatment(all P<0.05),and there were no statistically significant differences at 48 weeks compared to those at baseline(all P>0.05).In addition,the differences in average changes of the level of TG,TC,HDL-C,and LDL-C from weeks 4,12,24,and 48 to baseline between two groups were not statistically significant(all P>0.05).Multivariate Cox proportional risk model analysis showed that initiating ART with HIV RNA≥10^(5)copies/mL(compared with<10^(5)copies/mL)was associated with an increased risk of elevated LDL-C(hazard ratio=1.26,95%confidence interval:1.07-1.48,P=0.005).Conclusions:Transient elevations in blood lipid levels(TC,TG,HDL-C,and LDL-C)were observed in treatment-naïve adult male HIV/AIDS patients with BIC/FTC/TAF at 4 weeks,12 weeks,and 24 weeks of treatment.However,these levels did not differ significantly from baseline after 48 weeks of treatment,regardless of whether patients were in the BIC/FTC/TAF or 3TC+EFV+TDF group.
文摘Introduction:Human Immunodeficiency Virus(HIV)nonoccupational post-exposure prophylaxis(nPEP)clinics are specialized healthcare facilities that provide urgent medical interventions to individuals with potential high-risk HIV exposures.This study analyzed utilization patterns of HIV nPEP services in China and examined factors associated with medication adherence among consultees,providing evidence to inform further implementation and optimization of HIV nPEP interventions.Methods:We analyzed nPEP case data collected from the national nPEP data information system between November 1,2022,and November 1,2024,using SPSS 29.0 software.Chi-square tests were applied to analyze characteristics of nPEP consultees,and logistic regression models were used to identify factors influencing medication adherence and followup compliance among those who initiated treatment.Results:As of November 1,2024,924 nPEP clinics nationwide received 54,108 consultees,with 53,405(98.70%)initiating medication.Most individuals seeking services were male(88.63%),classified as high-risk(83.11%),and heterosexual with multiple partners(67.66%).The“BIC/FTC/TAF”regimen was selected by 63.07%of recipients.Nearly all users(99.03%)completed medication evaluation within 72 hours post-exposure.Among medication users,60.34%(30,650)adhered to the full 28-day regimen,and 60.10%(30,509)completed either onemonth or three-month follow-ups.Multivariate logistic regression analysis identified gender,exposure risk assessment results,exposure population classification,individual preferences,and medication regimen as significant factors influencing both 28-day medication adherence and follow-up compliance(P<0.05).Conclusions:nPEP clinic consultees in China are predominantly young male heterosexual individuals with multiple sexual partners,with most selecting the Biktarvy regimen.However,both current 28-day medication adherence and follow-up compliance rates remain suboptimal.High-risk men and those receiving the Biktarvy regimen demonstrate superior medication adherence and follow-up compliance compared to other groups.Further research is needed to develop targeted interventions to improve medication adherence and follow-up rates among nPEP recipients.Enhancing adherence and follow-up should be prioritized in future interventions,supported by continuous monitoring to inform timely intervention strategy adjustments.
