{"id":5802,"date":"2019-03-30T10:36:52","date_gmt":"2019-03-30T03:36:52","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5802"},"modified":"2019-03-30T10:37:25","modified_gmt":"2019-03-30T03:37:25","slug":"nghien-cuu-phac-do-phoi-hop-rifapentine-va-isoniazid","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/nghien-cuu-phac-do-phoi-hop-rifapentine-va-isoniazid\/","title":{"rendered":"Nghi\u00ean c\u1ee9u ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p Rifapentine v\u00e0 Isoniazid"},"content":{"rendered":"<h2>[NEJM] Nghi\u00ean c\u1ee9u ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p Rifapentine v\u00e0 Isoniazid trong v\u00f2ng 1 th\u00e1ng nh\u1eb1m d\u1ef1 ph\u00f2ng lao \u1edf b\u1ec7nh nh\u00e2n HIV<\/h2>\n<p>Susan Swindells, Ritesh Ramchandani, Amita Gupta, Constance A. Benson v\u00e0 c\u1ed9ng s\u1ef1 thu\u1ed9c nh\u00f3m nghi\u00ean c\u1ee9u BRIEF TB\/A5279<\/p>\n<p>\u0110\u0103ng t\u1ea3i ng\u00e0y 14\/03\/2019 tr\u00ean NEJM. DOI: 10.1056\/NEJMoa1806808<\/p>\n<p>Lao l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong h\u00e0ng \u0111\u1ea7u \u1edf b\u1ec7nh nh\u00e2n nhi\u1ec5m HIV. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng v\u1eabn c\u00f3 hi\u1ec7u qu\u1ea3, song c\u00e1c ph\u00e1c \u0111\u1ed3 hi\u1ec7n h\u00e0nh c\u00f2n nhi\u1ec1u h\u1ea1n ch\u1ebf do kh\u00f3 th\u1ef1c hi\u1ec7n v\u00e0 t\u1ec9 l\u1ec7 b\u1ec7nh nh\u00e2n ho\u00e0n th\u00e0nh \u0111i\u1ec1u tr\u1ecb th\u1ea5p. \u0110\u00e3 c\u00f3 nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean m\u00f4 h\u00ecnh chu\u1ed9t nhi\u1ec5m lao ti\u1ec1m \u1ea9n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u00e0ng ng\u00e0y b\u1eb1ng ph\u1ed1i h\u1ee3p rifapentine v\u00e0 isoniazid trong v\u00f2ng m\u1ed9t th\u00e1ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb h\u00e0ng tu\u1ea7n ph\u1ed1i h\u1ee3p rifapentine v\u00e0 isoniazid trong 3 th\u00e1ng, v\u00e0 \u00edt nh\u1ea5t c\u0169ng c\u00f3 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ph\u00e1c \u0111\u1ed3 6 th\u00e1ng isoniazid \u0111\u01a1n \u0111\u1ed9c.<\/p>\n<p>V\u00ec v\u1eady c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 ti\u1ebfn h\u00e0nh th\u1eed nghi\u1ec7m kh\u00f4ng thua k\u00e9m c\u00f3 ng\u1eabu nhi\u00ean ho\u00e1, nh\u00e3n m\u1edf, pha 3 nh\u1eb1m so s\u00e1nh hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n c\u1ee7a ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb h\u00e0ng ng\u00e0y b\u1eb1ng ph\u1ed1i h\u1ee3p rifapentine v\u00e0 isoniazid trong 1 th\u00e1ng (nh\u00f3m 1 th\u00e1ng) v\u1edbi ph\u00e1c \u0111\u1ed3 9 th\u00e1ng isoniazid \u0111\u01a1n \u0111\u1ed9c (nh\u00f3m 9 th\u00e1ng) tr\u00ean b\u1ec7nh nh\u00e2n nhi\u1ec5m HIV s\u1ed1ng trong khu v\u1ef1c c\u00f3 t\u1ea7n su\u1ea5t hi\u1ec7n m\u1eafc cao v\u1ec1 b\u1ec7nh lao, ho\u1eb7c c\u00f3 b\u1eb1ng ch\u1ee9ng nhi\u1ec5m lao ti\u1ec1m \u1ea9n. \u0110i\u1ec3m k\u1ebft th\u00fac ch\u00ednh l\u00e0 bi\u1ebfn c\u1ed1 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc lao l\u1ea7n \u0111\u1ea7u ho\u1eb7c t\u1eed vong do lao ho\u1eb7c b\u1ea5t c\u1ee9 nguy\u00ean nh\u00e2n n\u00e0o kh\u00e1c. Ph\u00e2n t\u00edch s\u1ebd cho th\u1ea5y kh\u00f4ng thua k\u00e9m n\u1ebfu gi\u1edbi h\u1ea1n tr\u00ean c\u1ee7a kho\u1ea3ng tin c\u1eady 95% v\u1ec1 \u0111\u1ed9 ch\u00eanh l\u1ec7ch gi\u1eefa c\u00e1c nh\u00f3m v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng bi\u1ebfn c\u1ed1 tr\u00ean 100 ng\u01b0\u1eddi-n\u0103m l\u00e0 th\u1ea5p h\u01a1n 1,25.<\/p>\n<p>Trong t\u1ed5ng s\u1ed1 3000 \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u00ean c\u1ee9u v\u1edbi th\u1eddi gian theo d\u00f5i trung v\u1ecb 3,3 n\u0103m, 54% \u0111\u1ed1i t\u01b0\u1ee3ng l\u00e0 n\u1eef gi\u1edbi, s\u1ed1 l\u01b0\u1ee3ng CD4+ trung v\u1ecb l\u00e0 470 t\u1ebf b\u00e0o\/ mm kh\u1ed1i, m\u1ed9t n\u1eeda s\u1ed1 b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng retrovirus. Bi\u1ebfn c\u1ed1 \u1edf \u0111i\u1ec3m k\u1ebft th\u00fac ch\u00ednh \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u00ean 32\/1488 b\u1ec7nh nh\u00e2n (2%) \u1edf nh\u00f3m 1 th\u00e1ng v\u00e0 33\/1498 b\u1ec7nh nh\u00e2n (2%) \u1edf nh\u00f3m 9 th\u00e1ng, v\u1edbi t\u1ea7n su\u1ea5t m\u1eafc m\u1edbi l\u1ea7n l\u01b0\u1ee3t l\u00e0 0,65\/100 ng\u01b0\u1eddi-n\u0103m v\u00e0 0,67\/100 ng\u01b0\u1eddi-n\u0103m (\u0111\u1ed9 ch\u00eanh t\u1ea7n su\u1ea5t \u1edf nh\u00f3m 1 th\u00e1ng l\u00e0 \u22120,02\/100 ng\u01b0\u1eddi-n\u0103m; gi\u1edbi h\u1ea1n tr\u00ean c\u1ee7a kho\u1ea3ng tin c\u1eady 95% l\u00e0 0,30). Bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i nghi\u00eam tr\u1ecdng x\u1ea3y ra \u1edf 6% s\u1ed1 b\u1ec7nh nh\u00e2n trong nh\u00f3m 1 th\u00e1ng v\u00e0 7% s\u1ed1 b\u1ec7nh nh\u00e2n trong nh\u00f3m 9 th\u00e1ng (P=0,07). T\u1ec9 l\u1ec7 ho\u00e0n th\u00e0nh ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u1edf nh\u00f3m 1 th\u00e1ng cao h\u01a1n c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea so v\u1edbi nh\u00f3m 9 th\u00e1ng (97% so v\u1edbi 90%, P&lt;0,001).<\/p>\n<p>T\u1eeb \u0111\u00f3 c\u00e1c t\u00e1c gi\u1ea3 r\u00fat ra k\u1ebft lu\u1eadn: ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p rifapentine v\u00e0 isoniazid trong 1 th\u00e1ng kh\u00f4ng thua k\u00e9m ph\u00e1c \u0111\u1ed3 9 th\u00e1ng isoniazid \u0111\u01a1n \u0111\u1ed9c trong d\u1ef1 ph\u00f2ng lao \u1edf b\u1ec7nh nh\u00e2n HIV. T\u1ec9 l\u1ec7 b\u1ec7nh nh\u00e2n ho\u00e0n th\u00e0nh ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u1edf nh\u00f3m 1 th\u00e1ng cao h\u01a1n c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea so v\u1edbi nh\u00f3m c\u00f2n l\u1ea1i.<\/p>\n<p>Ngu\u1ed3n: <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1806808\" rel=\"noopener\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1806808<\/a><\/p>\n<p>D\u1ecbch b\u1edfi: <a href=\"https:\/\/www.facebook.com\/duoclylamsangvn\/\" rel=\"noopener\">Trung t\u00e2m D\u01b0\u1ee3c l\u00fd l\u00e2m s\u00e0ng tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"[NEJM] Nghi\u00ean c\u1ee9u ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p Rifapentine v\u00e0 Isoniazid trong v\u00f2ng 1 th\u00e1ng nh\u1eb1m d\u1ef1 ph\u00f2ng lao \u1edf b\u1ec7nh nh\u00e2n HIV Susan Swindells, Ritesh Ramchandani, Amita Gupta, Constance A. Benson v\u00e0 c\u1ed9ng s\u1ef1 thu\u1ed9c nh\u00f3m nghi\u00ean c\u1ee9u BRIEF TB\/A5279 \u0110\u0103ng t\u1ea3i ng\u00e0y 14\/03\/2019 tr\u00ean NEJM. DOI: 10.1056\/NEJMoa1806808 Lao l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n [&#8230;]\n","protected":false},"author":1,"featured_media":5803,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5802","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5802","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=5802"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5802\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5803"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5802"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5802"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5802"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}