TDF/3TC aizsargefekts
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12.07.2020
HIV pozitîvie pacienti ir mazâk jutîgi pret Covid-19, ja viòi lieto tenofovîra (TDF formâ)/emtricitabîna kombinâciju, liecina Spânijâ veiktâ kohortas pçtîjuma rezultâti.
Pçtîjums tika veikts 60 klînikâs, kas atrodas daþâdâs valsts daïâs, un tajâ piedalîjâs 77590 pacientu, kuriem diagnosticçts HIV. 236 no viòiem tika diagnosticçts Covid-19, no kuriem 151 tika nogâdâts slimnîcâs (15 nonâca intensîvâs terapijas nodaïâs, 20 cilvçki nomira).
Pçtîjuma rezultâti liecina, ka risks saslimt ar Covid-19 HIV pacientiem nav lielâks kâ pârçjai populâcijai. Turklât tie, kuri lieto tenofovîru (TDF)/emtricitabînu (FTC) (kombinâcija, ko izmanto HIV infekcijas ârstçðanai un HIV pirmskontakta profilaksei), ir mazâk jutîgi pret Covid-19 nekâ pacienti, kas ârstçti, izmantojot citas shçmas.
Þurnâlâ Annals of Internal Medicine publicçtâ pçtîjuma autori uzskata, ka nepiecieðami papildu testi, lai apstiprinâtu daþâdu antiretrovîrusu preparâtu efektivitâti Covid-19 ârstçðanâ. Ðo datu apstiprinâðana bûtu liels sasniegums, lai novçrstu medicînas personâla un cilvçku no îpaðâ riska grupu inficçðanos.
Spânijâ vairâk nekâ 90% HIV pozitîvu cilvçku saòem antiretrovîrusu terapiju.
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Source: Annals of Internal Medicine | «Incidence and Severity of Covid-19 in HIV-Positive Persons Receiving Antiretroviral Therapy. A Cohort Study» | https://www.acpjournals.org/doi/10.7326/M20-3689 |
<... Abstract
Background:
The incidence and severity of coronavirus disease 2019 (Covid-19) among HIV-positive persons receiving antiretroviral therapy (ART) have not been characterized in large populations.
Objective:
To describe the incidence and severity of Covid-19 by nucleos(t)ide reverse transcriptase inhibitor (NRTI) use among HIV-positive persons receiving ART.
Design:
Cohort study.
Setting:
HIV clinics in 60 Spanish hospitals between 1 February and 15 April 2020.
Participants:
77 590 HIV-positive persons receiving ART.
Measurements:
Estimated risks (cumulative incidences) per 10 000 persons and 95% CIs for polymerase chain reaction–confirmed Covid-19 diagnosis, hospitalization, intensive care unit (ICU) admission, and death. Risk and 95% CIs for Covid-19 diagnosis and hospital admission by use of the NRTIs tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), tenofovir alafenamide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and others were estimated through Poisson regression models.
Results:
Of 77 590 HIV-positive persons receiving ART, 236 were diagnosed with Covid-19, 151 were hospitalized, 15 were admitted to the ICU, and 20 died. The risks for Covid-19 diagnosis and hospitalization were greater in men and persons older than 70 years. The risk for Covid-19 hospitalization was 20.3 (95% CI, 15.2 to 26.7) among patients receiving TAF/FTC, 10.5 (CI, 5.6 to 17.9) among those receiving TDF/FTC, 23.4 (CI, 17.2 to 31.1) among those receiving ABC/3TC, and 20.0 (CI, 14.2 to 27.3) for those receiving other regimens. The corresponding risks for Covid-19 diagnosis were 39.1 (CI, 31.8 to 47.6), 16.9 (CI, 10.5 to 25.9), 28.3 (CI, 21.5 to 36.7), and 29.7 (CI, 22.6 to 38.4), respectively. No patient receiving TDF/FTC was admitted to the ICU or died.
Limitation:
Residual confounding by comorbid conditions cannot be completely excluded.
Conclusion:
HIV-positive patients receiving TDF/FTC have a lower risk for Covid-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV. ...>
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