Treatment Outcome and Adverse Events of Tenofovir Disoproxil Fumarate Based Regimens as Compared to Zidovudine Based Regimens Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis of Observational Studies.

The Open AIDS Journal Pub Date : 2018-05-31 eCollection Date: 2018-01-01 DOI:10.2174/1874613601812010038

Adane Teshome Kefale, Tegene Legese Dadi, Tessema Tsehay Biru, Teshale Ayele Mega

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引用次数: 3

Abstract

Background: Findings from different studies report inferior clinical and virologic efficacy with TDF/3TC/NVP. But, some studies show that, there was no statistically significant difference in mortality among ZDV and TDF based regimens. The objective of this review was to systematically identify, appraise and synthesize the best available evidence on efficacy and safety of TDF based regimen as compared to ZDV based regimens.

Methods: A three-step search strategy was used to locate published and unpublished studies. First, an initial limited search of google was undertaken followed by analysis of text words. A second extensive search was undertaken. We searched the PubMed, EMBASE, Google Scholar, Medline, and CINHAL. We did the initial search for articles on July 11-18, 2016, and updated the results on May 13, 2017.Third, the reference lists of all identified articles was searched for additional studies.

Results: ZDV based regimens had better outcome on prevention of mortality (OR=1.31, 95%CI (1.14, 1.50), I² = 0%, Chi² = 2.51), and lower virologic failure (OR = 1.44, 95% CI [1.18, 1.76], chi² = 5.91, P= 0.003, I² =83%) while, TDF based regimens were more tolerable (OR=0.15, 95%CI (0.08, 0.30), I² = 40%, Chi² = 3.31). The difference in incidence of opportunistic infection is not significant (OR = 0.83, 95% CI [0.52, 1.32], chi² = 0.11, P= 0.42, I² =0%).

Conclusion: There is lower mortality and lower virologic failure in ZDV group, but better safety profile among TDF based regimens.

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在HIV/AIDS患者中，以富马酸替诺福韦二奥proxil为基础的治疗结果和不良事件与以齐多夫定为基础的治疗方案的比较:观察性研究的系统回顾和荟萃分析

背景:不同的研究结果表明，TDF/3TC/NVP的临床和病毒学疗效较差。但是，一些研究表明，在以ZDV和TDF为基础的方案中，死亡率没有统计学上的显著差异。本综述的目的是系统地识别、评估和综合基于TDF的方案与基于ZDV的方案相比的有效性和安全性的最佳现有证据。方法:采用三步搜索策略定位已发表和未发表的研究。首先，在谷歌上进行了初步的有限搜索，然后对文本单词进行了分析。进行了第二次广泛搜查。我们检索了PubMed, EMBASE, Google Scholar, Medline和CINHAL。我们在2016年7月11日至18日对文章进行了初步搜索，并在2017年5月13日更新了结果。第三，检索所有确定的文献的参考文献列表以查找其他研究。结果:以ZDV为基础的方案在预防死亡率方面效果较好(OR=1.31, 95%CI (1.14, 1.50)， I2 = 0%， Chi2 = 2.51)，病毒学失败率较低(OR= 1.44, 95%CI [1.18, 1.76]， Chi2 = 5.91, P= 0.003, I2 =83%)，而以TDF为基础的方案耐受性较好(OR=0.15, 95%CI (0.08, 0.30)， I2 = 40%， Chi2 = 3.31)。机会性感染发生率差异无统计学意义(OR = 0.83, 95% CI [0.52, 1.32]， chi2 = 0.11, P= 0.42, I2 =0%)。结论:ZDV组死亡率和病毒学失败发生率较低，但安全性优于TDF组。

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The Open AIDS Journal

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