艾滋病抗病毒治疗患者依非韦伦血药浓度及相关因素的分析

新发传染病电子杂志 ›› 2019, Vol. 4 ›› Issue (2): 103-107.

艾滋病抗病毒治疗患者依非韦伦血药浓度及相关因素的分析

赵方, 李巍, 郑祎, 刘晓宁, 周泱, 张路坤, 彭巧丽, 王辉, 何云

1.南方科技大学附属第二医院/深圳市第三人民医院,广东深圳 518112

出版日期:2019-06-30 发布日期:2020-07-21
通讯作者: 何云, Email：yuer-he@163.com

Analysis of plasma efavirenz concentration and related factors in HIV/AIDS patients

ZHAO Fang, LI Wei, ZHEN Yi, LIU Xiao-ning, ZHOU Yang, ZHANG Lu-kun, PENG Qiao-li, Wang Hui, He Yun

The Second Affiliated hospital of South University of science and technology,Shenzhen Third People's Hospital, Guangdong Shenzhen 518112, China

Online:2019-06-30 Published:2020-07-21

摘要/Abstract

摘要： 目的调查深圳地区艾滋病抗病毒治疗患者服用依非韦伦（efavirenz,EFV）标准剂量（600mg）后血浆中药物浓度与不良反应的相互关系,探索影响药物浓度的相关因素,为艾滋病患者临床上合理应用依非韦伦提供剂量调整依据。方法对深圳市第三人民医院艾滋病门诊就诊的333例艾滋病抗病毒经治患者（使用EFV>3个月且病毒载量<500copies/ml）开展横断面研究,通过高效液相色谱测定患者血浆中的EFV稳态血药浓度,并采集患者相关临床信息,分析药物浓度与不良反应的相互关系,及影响药物浓度的相关因素。结果深圳地区汉族人群EFV血药浓度中位数为 3.3mg/L,四分位间距（Q1 2.5,Q3 4.3）。其中229例（68.4%）患者的血药浓度位于最佳治疗浓度窗口（1~4mg/L）,4例（1.2%）小于1mg/L,100例（30.3%）大于4mg/L。多因素分析结果显示,体重≤60Kg和BMI≤22 Kg/m2与EFV血药浓度大于4mg/L存在明显相关。除头晕症状外,EFV的其他不良反应与EFV血药浓度是否大于4mg/L无明显相关性。结论深圳地区汉族人群EFV血药浓度水平偏高,BMI和体重均能较好地反映血药浓度情况。临床可根据BMI或体重对EFV进行剂量调整。

关键词: 艾滋病毒/艾滋病, 依非韦伦, 不良反应, 血药浓度, 体重指数

Abstract: Objective To investigate the relationship between plasma drug concentration and adverse reactions after taking efavirenz (EFV) standard dose (600mg) in HIV/AIDS patients, and to explore the factors affecting drug concentration, so as to provid basis forrational dose adjustment of EFV.Methods Total of 333 HIV-infected outpatients in Shenzhen the third people's hospital were enrolled (receiving EFV>3 months and viral load <500copies/ml).General demographic and clinical information were collected by patient interview. The plasma concentration of EFV in the patient's plasma was measured by high performance liquid chromatography and the clinical information of the patient was collected. The concentration and adverse drug reactions of EFV and the associated factors were analyzed by SPSS.Result sThe median plasma EFV concentration in the Han population of Shenzhen was 3.3 mg/L, the interquartile range (Q1 2.5, Q3 4.3). Among them, 229 (68.4%) were in the optimal therapeutic concentration window (1~4mg/L), 4 (1.2%) were less than 1mg/L, and 100 (30.3%) were greater than 4mg/L. Multivariate analysis showed that weight ≤60Kg and BMI≤22 Kg/m2 were significantly associated with EFV plasma concentrations greater than 4 mg/L. Exception of the dizziness symptom, there was no significant association between other adverse events of EFV and the highplasma EFV concentration greater than 4 mg/L.Conclusion The plasma EFV concentration in the Han population of Shenzhen is high, and BMI and body weight can better reflect the blood concentration. Therefore, dose adjustment of EFV can be performed based on BMI or body weight..

Key words: HIV/AIDS, Efavirenz, Adverse drug reactions, Plasma concentration, Body mass indexliposome

赵方, 李巍, 郑祎, 刘晓宁, 周泱, 张路坤, 彭巧丽, 王辉, 何云. 艾滋病抗病毒治疗患者依非韦伦血药浓度及相关因素的分析[J]. 新发传染病电子杂志, 2019, 4(2): 103-107.

ZHAO Fang, LI Wei, ZHEN Yi, LIU Xiao-ning, ZHOU Yang, ZHANG Lu-kun, PENG Qiao-li, Wang Hui, He Yun. Analysis of plasma efavirenz concentration and related factors in HIV/AIDS patients[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(2): 103-107.

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