ABSTRACT
OBJECTIVE: To investigate the influence of HBV and HCV co-infection on the plasma concentrations, efficacy and hepatotoxicity of efavirenz in HIV/AIDS patients. METHODS: The peripheral blood HIV RNA viral loads, CD4+ T-cells, liver function and plasma efavirenz concentrations of 494 cases of HIV monoinfected, HIV/HBV and HIV/HCV co-infected patients were determined by PCR, flow cytometry, automatic biochemical analysis and HPLC and statically compared. RESULTS: The median (IQR) efavirenz concentrations at week 48 of HIV-monoinfected patients, HBV- and HCV-coinfected patients were 3.781 mg•L-1(3.012-4.980 mg•L-1), 3.057 mg•L-1(2.040-5.144 mg•L-1), 2.557 mg•L-1(2.212-4.334 mg•L-1), respectively (P<0.05), while the proportions of patients achieving partial and complete virus inhibition were 78.59%, 76.36%, and 100.00%, respectively. The mean±SD CD4 cell counts steadily increased over time from (290±118), (273±120), and (282±134)cells•mm-3 at baseline to (442±184), (457±221), and (391±151) cells•mm-3 at week 48, respectively(P<0.05). The indexes of liver functions were all basically within normal limits. CONCLUSION: The immune reconstruction of most patients is smooth and they also have favorable prognosis. Co-infection with HBV or HCV will not cause accumulation of efavirenz or hepatic damage. Efavirenz is safe and effective for treatment-naive HIV/AIDS patients with HBV and HCV co-infection.
ABSTRACT
OBJECTIVE: Individuals taking aspirin but who fail to appropriately respond to the medication may remain at higher risk of thrombotic events. To provide reference for rational use of aspirin and reduce the risk of adverse reactions, clinical pharmacists need to comprehend the status of aspirin resistance. METHODS: We have reviewed, analyzed, and summarized domestic and foreign literatures published in the last five years that are related to aspirin resistance. RESULTS: The term "aspirin resistance" still has no standard accepted definition in the literature. Researchers focus on molecular insights into the mechanisms of aspirin resistance. The absolute as well as relative contributions of various factors to the phenomenon of aspirin resistance are the subject of current research. There are diverse platelet function testing methods and each has its strengths and weaknesses, which will greatly increase the difficulty of selection. CONCLUSION: In order to have a comprehensive assessment and interpretation of laboratory data, clinical pharmacists need to understand the research progress of aspirin resistance, which will promote personalized medication of aspirin.