课件：抗病毒治疗进展.ppt

* * * Challenges with first-generation NNRTIs Unfortunately, first-generation NNRTIs are hindered by their treatment-limiting safety concerns,1–5 and development of cross resistance.6,7 The most commonly reported AEs with EFV-based regimens are CNS- and psychiatric-related events, including dizziness, insomnia, impaired concentration, somnolence, abnormal dreams and hallucinations. However, these events are generally predominately mild in severity and resolve within 2–4 weeks of therapy.2 Rash is the most frequently reported AE with NVP.1 References van Leth F, Andrews S, Grinsztejn B, et al. The effect of baseline CD4 cell count and HIV-1 viral load on the efficacy and safety of nevirapine or efavirenz-based first-line HAART. AIDS 2005;19:463–71. Frampton JE, Croom KF. Efavirenz/emtricitabine/tenofovir disoproxil fumarate: triple combination tablet. Drugs 2006;66:1501–12. Sanne I, Mommeja-Marin H, Hinkle J, et al. Severe hepatotoxicity associated with nevirapine use in HIV-infected subjects. J Infect Dis 2005;191:825–9. Haubrich R, Riddler S, Ribaudo H, et al. Initial viral decay to assess the relative antiretroviral potency of PI-, NNRTI-, and NRTI-sparing regimens for first line therapy of HIV-1 infection: ACTG 5160s (sub-study of A5142). 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA, USA, 25–28 February 2007. Abstract 137. US DHHS. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. December 2009 [accessed 16 December 2009]. Available at: /contentfiles/AdultandAdolescentGL.pdf. Delaugerre C, Rohban R, Simon A, et al. Resistance profile and cross-resistance of HIV-1 among patients failing a non-nucleoside reverse transcriptase inhibitor-containing regimen. J Med Virol 2001;65:445–8. Antinori A, Zaccarelli M, Cingolani A, et al. Cross-resistance among nonnucleoside reverse transcriptase inhibitors limits recycling efavirenz after nevirapine failure. AIDS Res Hum Retroviruses 2002;18:835–8