人民卫生出版社系列期刊
ISSN 2096-2738 CN 11-9370/R

中国科技核心期刊(中国科技论文统计源期刊)
2020《中国学术期刊影响因子年报》统计源期刊

新发传染病电子杂志 ›› 2024, Vol. 9 ›› Issue (4): 57-60.doi: 10.19871/j.cnki.xfcrbzz.2024.04.012

• 病例报道 • 上一篇    下一篇

艾博韦泰联合多替拉韦治疗HIV感染/AIDS多重耐药1例报道

安永辉, 杨萱, 孙燕   

  1. 郑州市第六人民医院感染科,河南 郑州 450015
  • 收稿日期:2024-03-05 出版日期:2024-08-31 发布日期:2024-10-10
  • 通讯作者: 安永辉,Email:ayh929@126.com
  • 基金资助:
    2023年度河南省重点研发与推广专项(科技攻关)(232102311081)

A case of AIDS patient with HIV multi-drug resistance treated with albuvirtide combined with dolutegravir

An Yonghui, Yang Xuan, Sun Yan   

  1. Department of Infectious Disease, No.6 People’s Hospital of Zhengzhou, Henan Zhengzhou 450015, China
  • Received:2024-03-05 Online:2024-08-31 Published:2024-10-10

摘要: 随着抗反转录病毒治疗(antiretroviral therapy,ART)的快速启动和推广,HIV感染已成为一种可以治疗的慢性传染病,然而治疗期间若ART不规范或患者依从性差可引起耐药变异。本研究报道1例30岁多重耐药HIV感染者使用艾博韦泰(albuvirtide,ABT)联合多替拉韦(dolutegravir,DTG)的治疗经过。患者治疗失败后行HIV耐药检测,结果显示患者对核苷类逆转录酶抑制剂、非核苷类逆转录酶抑制剂及蛋白酶抑制剂中的多种药物存在不同程度耐药,在既往药物中仅对整合酶抑制剂类药物敏感。结合患者HIV耐药检测结果,治疗方案更换为“ABT+DTG”,患者病毒复制被成功抑制,且患者在8个月治疗过程中免疫功能逐步提升。而后因个人原因,患者短暂停用“ABT+DTG”治疗1个月,免疫水平下降,病毒载量出现反跳。后行“ABT+DTG”方案治疗至2023年3月,CD4+T淋巴细胞计数平稳升高至291×106个/L,病毒载量持续降低至小于40×103copies/L,治疗期间患者耐受性及安全性较好。提示ABT联合DTG方案是HIV多重耐药患者一种新的治疗选择。

关键词: 艾博韦泰, 人免疫缺陷病毒, 艾滋病, 多重耐药, 抗反转录病毒治疗, 病例报道

Abstract: With the rapid initiation and application of antiretroviral therapy (ART), Human immunodeficiency virus (HIV) infection has become a treatable chronic infectious disease. However, during the course of treatment, improper use of ART or poor patient adherence may lead to the development of drug-resistant mutations. This case report shares the treatment experience of a 30-year-old AIDS patient resistant to various drugs to varying degrees, who was treated with albuvirtide (ABT) in combination with dolutegravir (DTG). In this case, the patient underwent HIV resistance testing after treatment failure, and the results showed that the patient had varying degrees of resistance to a variety of drugs in nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors, and was only sensitive to integrase inhibitors in the previous drugs. Combined with the resμlts of the patient's HIV drug resistance test, the treatment regimen was changed to "ABT+DTG", which successfully improved the viral replication of the patient, and the patient's immune function gradually improved during the eight-month treatment process. Due to economic reasons, the patient temporarily stopped the treatment of "ABT+DTG" for 1 month, and the patient's immune level decreased and the viral load rebounded. After continuous treatment with the "ABT+DTG" regimen, the CD4+T cell count increased steadily to 291 copies/μl and the viral load continued to decrease to less than 40 copies/ml until March 2023, which was well tolerated and safe during the treatment. These resμlts suggest that ABT combined with DTG is a new treatment option for patients with HIV multidrug resistance.

Key words: Albuvirtide, Human immunodeficiency virus, Acquired immune deficiency syndrome, Drug resistance, Antiretroviral therapy, Case report

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