tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2020-98-5-24-31tiblj-1422Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESВирусологическая и иммунологическая эффективность метаболически благоприятных схем антиретровирусной терапии у больных ВИЧ-инфекцией, ранее не получавших леченияVirological and immunological efficacy of metabolically favorable antiretroviral therapy regimens in HIV patients who had no previous treatmentВеселоваЕ. И.VeselovaE. I.drveselovae@mail.ruКочарянК. А.KocharyanK. A.ЛовачеваО. В.LovachevaO. V.КаминскийГ. Д.KaminskiyG. D.СамойловаА. Г.SamoylovaA. G.ВасильеваИ. А.VasilyevaI. A.ФГБУ «Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний» МЗ РФРоссияNational Medical Research Center of Phthisiopulmonology and Infectious DiseasesRussian Federation2020020620209852431Copyright © Веселова Е.И., Кочарян К.А., Ловачева О.В., Каминский Г.Д., Самойлова А.Г., Васильева И.А., 20202020Веселова Е.И., Кочарян К.А., Ловачева О.В., Каминский Г.Д., Самойлова А.Г., Васильева И.А.Veselova E.I., Kocharyan K.A., Lovacheva O.V., Kaminskiy G.D., Samoylova A.G., Vasilyeva I.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1422Цель исследования

Цель исследования: у больных ВИЧ-инфекцией, ранее не получавших лечения, изучить эффективность и безопасность метаболически благоприятных схем антиретровирусной терапии (АРТ), их влияние на уровень РНК ВИЧ, количество CD4, CD8 T-лимфоцитов, соотношение CD4/CD8.

Материалы и методы

Материалы и методы. В исследование включено 80 пациентов с ВИЧ-инфекцией, ранее не получавших АРТ, из них 67 – без клинических проявлений ВИЧ-инфекции, 13 – с ВИЧ-ассоциированными заболеваниями. Оценивалась вирусологическая и иммунологическая эффективность трех схем АРТ: рилпивирин + эмтрицитабин + тенофовир (RPV + FTC + TDF); долутегравир, эмтрицитабин, тенофовир (DTG, FTC, TDF); ралтегравир, этравирин, ламивудин (RAL, ETR, 3TC) в течение первых 6 мес. лечения.

Результаты

Результаты. К концу 6-го мес. АРТ скорость снижения вирусной нагрузки относительно начального показателя повышалась в ряду RPV + FТС + TDF < RAL, ETR, 3TC < DTG, FТС, TDF. Количество CD4 Т-лимфоцитов и соотношение CD4/CD8 повышались при всех трех схемах АРТ, количество CD8 Т-лимфоцитов изменялось в зависимости от схемы лечения, наличия или отсутствия клинических проявлений. Оценка эффективности АРТ должна проводиться с учетом клинической картины ВИЧ-инфекции. Для оценки эффективности лечения необходимо контролировать вирусную нагрузку и три иммунологических показателя: количество CD4, CD8 Т-лимфоцитов и соотношение CD4/CD8.

The objective

The objective: to study efficacy and safety of metabolically favorable antiretroviral therapy regimens (ART), their effect on HIV RNA levels, levels of CD4, CD8 T lymphocytes, and the ratio of CD4/CD8 in HIV patients who had no previous treatment.

Subjects and methods

Subjects and methods. The study included 80 patients with HIV infection who no received ART previously, 67 of them – without clinical manifestations of HIV infection, 13 – with HIV associated diseases. The virological and immunological efficacy of three ART regimens was evaluated: rilpivirine + emtricitabine + tenofovir (RPV + FTC + TDF); dolutegravir, emtricitabine, tenofovir (DTG, FTC, TDF); raltegravir, etravirine, lamivudine (RAL, ETR, 3TC) during the first 6 months of treatment.

Results

Results. By the end of the 6th month of ART, the rate of decrease of viral load compared to the initial level increased in the series RPV + FTS + TDF < RAL, ETR, 3TC < DTG, FTC, TDF. The number of CD4 T-lymphocytes and the ratio of CD4/CD8 increased in all three ART regimens; the number of CD8 T-lymphocytes varied depending on the treatment regimen, the presence or absence of clinical manifestations. The assessment of ART efficacy should be based on the clinical signs of HIV infection. To assess treatment efficacy, it is necessary to control the viral load and three immunological parameters: the number of CD4, CD8 T-lymphocytes, and the ratio of CD4/CD8.

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The authors declare that there are no conflicts of interest present.