ผลงานวิจัยที่ได้รับรางวัล

R2R

 

หมอวีร์มีจดหมายน้อยมาแจ้งให้ทราบว่าได้นำเสนอผลงานวิจัยของสถาบันบำราศนราดูรในงาน "การประชุมใหญ่วิชาการประจำปี ครั้งที่ 32" ในวันที่ 20-23 ตุลาคม 2549  ของสมาคมโรคติดเชื้อแห่งประเทศไทย  ได้รับรางวัลที่ 1 จากการประกวดผลงานวิจัยประเภท Clinical research

ดิฉันขอนำมาแจ้งให้ทราบต่อค่ะ     ความจริงยังมีอีกหลายเรื่องที่บุคลากรของเราทำร่วมกับสถาบันอื่นๆและทำเองที่ดิฉันยังไม่ได้แจ้งเนื่องจากไม่ได้ส่งข้อมูลรายละเอียดมาให้ดิฉัน

คิดว่าเป็นเพียงตัวอย่างที่กระตุ้นแรงบันดาลใจนะคะ

ผลงานวิจัยที่ได้นำเสนอและได้รับรางวัลที่ 1 คือ

1. Three-year Survival and Risk of Mortality among Co-infected HIV and Tuberculosis Patients with/without Antiretroviral Therapy

Weerawat Manosuthi¹, Suthat Chottanapund¹, Supeda Thongyen¹, Achara Chaovavanich¹, Somnuek Sungkanuparph²¹Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, 11000, Thailand²Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

Background: The impact of antiretroviral therapy (ART) on survival among co-infected HIV and tuberculosis (TB) patients has not been well established.

  <p style="margin: 0in 0in 0pt" class="MsoNormal">Methods: A retrospective cohort study was conducted among HIV-infected patients with TB between January 2000 and December 2004. Patients were categorized into ART+ group (received ART) and ART- group (did not receive ART) and were followed until April 2005.</p>  <p style="margin: 0in 0in 0pt" class="MsoNormal">Results: A total of 1,003 patients were identified; 411 in ART+ group and 592 in ART- group. Median (IQR) CD4 count was 53 (20-129) cells/mm³. Survival rates at 1, 2, and 3 years after TB diagnosis were 96.1%, 94.0% and 87.7% for ART+ group; and 44.4%, 19.2% and 9.3% for ART- group (log rank test, p<0.001). Cox’s proportional hazard model showed that ART was associated with lower mortality rate; gastrointestinal TB and MDR-TB were associated with higher mortality rate (p<0.05). Among patients in ART+ group, the patients who were delayed ART ≥6 months after TB diagnosis had a higher mortality rate than those who were initiated ART <6 months after TB diagnosis (p=0.018, HR=2.651, 95%CI=1.152-6.102).</p><p> Conclusions: Antiretroviral therapy substantially reduces mortality rate among co-infected HIV/TB patients. Initiation of ART within six months of TB diagnosis is associated with greater survival.  </p><p> 2. Nevirapine Levels, Safety, 60-week Efficacy of NVP-based Antiretroviral Therapy and Treatment Outcomes of Tuberculosis in HIV-infected Patients with/without Concomitant Rifampicin  </p><p>Weerawat Manosuthi¹, Kiat Ruxrungtham², Sirirat Likanonsakul¹, Wisit Prasithsirikul¹, Yaowarat Inthong¹, Somnuek Sungkanuparph³¹ Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand² The HIV Netherlands-Australia-Thailand Research Collaboration, Thai Red Cross AIDS Research Centre, and Chulalongkorn University, Bangkok, Thailand </p><p style="margin: 0in 0in 0pt" class="MsoNormal">³ Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand</p><p style="margin: 0in 0in 0pt" class="MsoNormal"></p><p style="margin: 0in 0in 0pt" class="MsoNormal">Abstract</p>  <p style="margin: 0in 0in 0pt" class="MsoNormal">Background: The long-term clinical data of concomitant use of nevirapine (NVP) and rifampicin (RIF) is limited. </p>  <p style="margin: 0in 0in 0pt" class="MsoNormal">Methods: HIV/TB co-infected patients receiving RIF (group A) and HIV-monoinfection not receiving RIF (group B) were enrolled to receive d4T, 3TC, and NVP 400 mg/day. C₁₂ NVP level, plasma HIV-1 RNA, CD4, ALT and TB outcomes were studied.</p>  <p style="margin: 0in 0in 0pt" class="MsoNormal">Results: Of 140 patients (70/group), 68% male and median (IQR) CD4 29 cells/mm³. Mean±SD combined NVP levels at week 8 and 12 were 5.4±3.5 mg/l in group A and 6.6±3.1 mg/l in group B (p=0.048). At week 60 (with no RIF), Group A had increment of NVP level to 6.3±3.7 mg/l. Intention-to-treat analysis at week 60, 68.6% (48/70) in both groups achieved plasma HIV-1 RNA <50 copies/ml (OR=1.000, 95%CI=0.490-2.041, p=1.000). On-treatment analysis, 85.7% (48/56) in group A and 87.3% (48/55) in group B achieved plasma HIV-1 RNA <50 copies/ml (p=1.000). Mean±SD CD4 was 287±162 cells/mm³ and 295±167 cells mm³ in group A and B, respectively (p=0.806). In group A, the ALT values during and after RIF co-administration were not different (p=0.166). Five in group A (7%) and 6 in group B (8.6%) developed NVP-related rash (p=1.000). Of 70 tuberculosis in group A, 60 (86%) cured, 5 lost to follow-up, 3 died (1 MAC infection, 1 TB paradoxical reaction and 1 wasting) and 2 recurrent TB. </p><p style="margin: 0in 0in 0pt" class="MsoNormal"></p><p style="margin: 0in 0in 0pt" class="MsoNormal">Conclusions: NVP level in patients receiving RIF is somewhat lower than those not receiving RIF. However, there was no difference of the 60-week efficacy and safety between the groups. The cure rate of TB treatment is high. Thus, in a resource-limited setting, NVP 400 mg/day-based ART is an option for patients receiving RIF.  </p>