Ar četrām dienām nedēļā pietiek, lai efektīvi ārstētu HIV
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30.07.2019
Ar HIV inficētām personām rekomendē antiretrovīrusu preparātus lietot katru dienu, kaut ir dati, kas apstiprina, ka dažu antiretrovīrusu preparātu koncentrācija asinīs terapeitiskā līmenī saglabājas vairākas dienas pat gadījumos, ja uz dažām dienām pārtrauc terapiju. Turklāt adekvātā līmenī tiek saglabāta kontrole pār infekciju arī tad, ja tiek izlaista kāda deva.
Francijas Nacionālā HIV izpētes aģentūra (ANRS) izstrādājusi pētījumu protokolu «QUATUOR», kurā tika reģistrēti 647 cilvēki, kas saglabājuši nenosakāmu vīrusu slodzi ne mazāk kā 12 mēnešus un kuriem ne pret vienu no preparātu grupām neveidojās vīrusa rezistentas mutācijas.
Pētījuma pirmais rezultāts bija nenosakāmas vīrusu slodzes uzturēšana līdz 48. terapijas nedēļai un traucējumu nerašanās noteiktajā terapijas režīmā. Preparāta lietošanas cikla "4 no 7 dienām" rezultāti bija tikpat efektīvi kā šo zāļu grupas preparātu lietošana katru dienu. Turklāt netika atklātas nekādas atšķirības abu režīmu vīrusoloģiskās kontroles līmenī neatkarīgi no terapijas shēmām.
Šī novērojuma galvenais pētnieks doktors Rolands Lendmens norādīja, ka terapijas četru dienu režīms ārstēšanas izdevumus samazināja par 43%.
Pētījuma dalībniekus novēros vēl 48 nedēļas, lai pārliecinātos par iegūto rezultātu ticamību.
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Source: NAM Aidsmap | «Four days on, three days off HIV treatment just as effective as continuous therapy» | http://www.aidsmap.com/news/jul-2019/four-days-three-days-hiv-treatment-just-effective-continuous-therapy |
<... Taking anti-HIV medication four days a week was just as effective as daily treatment for people who already had a fully suppressed viral load, early data from a randomised trial presented at the 10th International AIDS Society Conference on HIV Science (IAS 2019) in Mexico City show.
The efficacy of the approach, particularly in relation to resistance, will need to be confirmed with longer follow-up than the 24-week data presented at the conference.
The study did not use a single regimen. Instead, the study randomised people with fully suppressed viral load taking a variety of antiretroviral regimens to continue taking their medication seven days a week or to change to taking medication on four consecutive days. Not only did the study find no difference between these strategies, but no difference in the virological safety of the two strategies was found between regimens based on protease inhibitors (PIs), integrase inhibitors or non-nucleoside reverse transcriptase inhibitors (NNRTIs).
Although long-term adherence to antiretroviral therapy is good, as demonstrated by high rates of virological suppression in people on treatment, a substantial minority of people report ongoing problems with adherence or periods of adherence difficulty. Many people with HIV say that it is tough to maintain perfect adherence year after year and have expressed interest in treatment strategies that would reduce the burden of taking medication.
People living with HIV are recommended to take antiretroviral medications every day as prescribed, but there is evidence from therapeutic drug monitoring that sufficient blood levels of some antiretrovirals persist for several days after dosing, keeping HIV under control even when a single dose is missed. Several studies have shown that skipping doses for two days does not affect long-term viral suppression. ...>
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