含PIs的双重治疗对初治AIDS的疗效和安全性的网状Meta分析

刘俊; 刘晓丹; 刘梦园

引用本文:	刘俊,刘晓丹,刘梦园.含PIs的双重治疗对初治AIDS的疗效和安全性的网状Meta分析[J].中国现代应用药学,2025,42(7):109-119.
	刘俊,LIUXiao-dan,LIUMeng-yuan.Effectiveness and Safety of PIs Based Dual Therapy in AIDS-na?ve patients: A Network Meta Analysis[J].Chin J Mod Appl Pharm(中国现代应用药学),2025,42(7):109-119.

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含PIs的双重治疗对初治AIDS的疗效和安全性的网状Meta分析
刘俊¹, 刘晓丹¹, 刘梦园²
1.天津市第二人民医院;2.廊坊卫生职业学院

摘要:

目的：系统评价以PIs为基础的双重治疗在初治艾滋病患者中的疗效及安全性。方法：计算机检索PubMed、Embase、Cochrane Library数据库,检索关于以PIs为基础的双重治疗在初治艾滋病患者的RCT,检索时限均为建库至2023年5月。采用Cochrane推荐的偏倚风险评估工具对纳入RCT进行质量评价。应用RevMan 5.4、Stata 14、ADDIS软件进行贝叶斯网状Meta分析。结果：纳入15篇RCT,总样本量3,407例,纳入8种干预措施。在HIV病毒抑制方面,排序为LPV/r+NRTIs＞TT＞DRV/r+INSTIs＞LPV/r+INSTIs＞DRV/r+CCR5＞LPV/r+PIs＞LPV/r+CCR5＞LPV/r+NNRTIs,不良反应事件方面,排序为LPV/r+CCR5＞LPV/r+PIs＞DRV/r+INSTIs＞TT＞LPV/r+INSTIs＞LPV/r+NRTIs＞DRV/r+CCR5,在CD4₊^{T淋巴细胞较基线的变化值}方面,排序为LPV/r+CCR5＞LPV/r+NRTIs＞TT＞DRV/r+INSTIs＞LPV/r+PIs＞LPV/r+NNRTIs。结论：根据本研究结果,以PIS为基础的双重治疗方案可作为初治艾滋病患者的简化治疗方案。其中,LPV/r+NRTIs和DRV/r+INSTIs的双重治疗方案可显著的抑制HIV病毒和修复免疫重建,且安全性好,有望替代传统的三药治疗方案。

关键词: 网状Meta分析艾滋病 PIs

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Effectiveness and Safety of PIs Based Dual Therapy in AIDS-na?ve patients: A Network Meta Analysis

刘俊¹, LIUXiao-dan¹, LIUMeng-yuan²

1.Tianjin Second People’s Hospital;2.Langfang Health Vocational College

Abstract:

ABSTRACT: OBJUECTVE To systematically evaluate the efficacy and safety of PIs based dual therapy in AIDS-na?ve patients. METHODS PubMed、Embase、Cochrane Library databases were electronically retrieved to gather RCT of PIs based dual therapy in AIDS-na?ve patients from their inception to May, 2023. The quality of included RCT wans evaluated using a Cochrane recommended bias risk assessment tool. Bayesian network Meta-analysis was performed by RevMan 5.4, Stata 14 and ADDIS. RESULTS 15 RCTs with a sample size of 3,407 were included, including 8 interventions. The order of viral suppression rate was LPV/r+NRTIs＞TT＞DRV/r+INSTIs＞LPV/r+INSTIs＞DRV/r+CCR5＞LPV/r+PIs＞LPV/r+CCR5＞LPV/r+NNRTIs, the order of adverse events rate was LPV/r+CCR5＞LPV/r+PIs＞DRV/r+INSTIs＞TT＞LPV/r+INSTIs＞LPV/r+NRTIs＞DRV/r+CCR5, the order of CD4+T cell count changes from baseline was LPV/r+CCR5＞LPV/r+NRTIs＞TT＞DRV/r+INSTIs＞LPV/r+PIs＞LPV/r+NNRTIs. CONCLUSION According to the results of this study, PIs based dual therapy can be used as a simplified treatment regimen for AIDS-na?ve patients. Among them, the dual therapy regimen of LPV/r+NRTIs and DRV/r+INSTIs can suppress HIV virus and repair immune reconstruction with good safety, which is expected to replace the traditional three-drugs therapy regimen.

Key words: network Meta-analysis AIDS/HIV PIs