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PLoS ONE:异烟肼预防性治疗可降低成年HIV感染者结核病发作风险

2015-11-20 MedSci MedSci原创

Dilla 大学健康科学和转诊医院公共健康部门Ayele HT和同事做了一项随机试验的系统回顾和荟萃分析,分析发现异烟肼预防性治疗具有降低成年HIV感染者结核病发作风险的作用。研究结果在PLoS ONE在线发表。

Dilla 大学健康科学和转诊医院公共健康部门Ayele HT和同事做了一项随机试验的系统回顾和荟萃分析,分析发现异烟肼预防性治疗具有降低成年HIV感染者结核病发作风险的作用。研究结果在PLoS ONE在线发表。

背景:感染HIV是TB(Tuberculosis ,肺结核)发作的一个重要的风险因素。ART(Anti-Retroviral Therapy,抗逆转录病毒治疗)可以改善感染HIV患者的预后,降低TB发作的风险。IPT(Isoniazid Preventive Therapy ,异烟肼预防性治疗)旨在减弱HIV感染伴结核感染并且处于结核潜伏期的患者身上活动性结核的进展。

研究目标:系统性回顾和综合分析IPT预防HIV感染者TB发作的效用。次要目标是评估IPT对于减缓HIV疾病进程,降低HIV感染者全因死亡率和ADR( adverse drug reaction ,药物不良反应)的作用。

检索策略:检索并提取出可用的相关英文文献,文献发表日期截止到在2015年9月11日。

纳入标准:研究性论著,使用随机对照试验比较IPT组与安慰剂组或空白对照组治疗成年HIV感染者的作用。

数据分析:定性评估包括纳入的研究的随机化分组和治疗方案等信息。使用随机效应模型估计不同研究的异质性。

主要结果:本研究评估了10个研究IPT和安慰剂的临床随机对照试验,共包含7619例HIV感染者。

研究发现IPT治疗HIV感染者与安慰剂组或空白对照组比较,总体减少35%的TB发作风险(RR=0.65, 95%CI 0.51-0.84);其中TST( Tuberculin Skin Test ,结合菌素皮试)阳性患者受益更大,合并相对危险度减少了52%(RR=0.48,95%CI 0.29-0.82);预测间距是0.13-1.81。

对于TST阴性或未知反应的成年HIV感染者,IPT治疗与安慰剂组或空白对照组治疗效果比较未见统计学显著性差异。

IPT也降低了所有受试者的HIV疾病进展的风险(RR=0.69,95%CI 0.48-0.99)。

行12个月IPT的成年HIV感染者倾向于降低TB死亡风险(RR=0.65, 95%CI 0.47-0.90),然而IPT并不能降低HIV感染者的全因死亡率。

虽然没有发现统计学差异,IPT可以增加HIV感染者发生药物不良反应的风险(RR=1.20,95%CI 1.20-1.71,P>0.05)。

只有一个研究评估IPT联合ART对预防TB发作和多重耐药TB产生的效用。

作者认为IPT可以减少成年HIV感染者TB发展的风险,特别是对于TST阳性患者来说效果更明显。然而还需要更多的研究提供证据来解释IPT对成年HIV感染者保护作用存在差异的原因。

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    2016-10-08 1e137bdcm70(暂无匿称)

    很不错的文章,对已有的研究性文章进行二次处理,整合后得出结论,值得临床科研设计的一种思路

    0

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    2016-09-05 doctorJiangchao

    继续学习

    0

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    2016-09-05 doctorJiangchao

    继续关注

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=142154, encodeId=a5a8142154d8, content=很不错的文章,对已有的研究性文章进行二次处理,整合后得出结论,值得临床科研设计的一种思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82351961337, createdName=1e137bdcm70(暂无匿称), createdTime=Sat Oct 08 21:05:44 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1789734, encodeId=eccf1e89734d6, content=<a href='/topic/show?id=6e4814388e2' target=_blank style='color:#2F92EE;'>#Plos one#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14388, encryptionId=6e4814388e2, topicName=Plos one)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fda6311, createdName=119337457, createdTime=Wed Jan 20 20:52:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111856, encodeId=6509111856bb, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Sep 05 23:15:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111857, encodeId=bc4d11185e1b, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Sep 05 23:15:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993010, encodeId=e09c1993010b5, content=<a href='/topic/show?id=f5ca1003182f' target=_blank style='color:#2F92EE;'>#预防性治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100318, encryptionId=f5ca1003182f, topicName=预防性治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77b32500129, createdName=12498aa2m62(暂无昵称), createdTime=Thu Dec 31 20:52:00 CST 2015, time=2015-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2034744, encodeId=482a2034e44d8, content=<a href='/topic/show?id=69c910030635' target=_blank style='color:#2F92EE;'>#预防性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100306, encryptionId=69c910030635, topicName=预防性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Sat May 28 20:52:00 CST 2016, time=2016-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253968, encodeId=da1e1253968ab, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Nov 22 02:52:00 CST 2015, time=2015-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290211, encodeId=27cf1290211fe, content=<a href='/topic/show?id=f774890827' target=_blank style='color:#2F92EE;'>#HIV感染者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8908, encryptionId=f774890827, topicName=HIV感染者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sun Nov 22 02:52:00 CST 2015, time=2015-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340387, encodeId=3297134038e4f, content=<a href='/topic/show?id=dbc0498101f' target=_blank style='color:#2F92EE;'>#异烟肼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49810, encryptionId=dbc0498101f, topicName=异烟肼)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/72D57F5B3E12B2BB53D6BD015D14DCD6/100, createdBy=a92e2500162, createdName=passed water, createdTime=Sun Nov 22 02:52:00 CST 2015, time=2015-11-22, status=1, ipAttribution=)]
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