摘要
目的分析一线药物治疗失败HIV/AIDS患者的治疗前耐药特征。方法回顾性分析2014-2019年在北京地坛医院启动免费抗病毒治疗且发生一线治疗失败患者的人口学信息、基线特征及治疗前耐药情况。结果140例一线治疗失败患者进行了治疗前耐药检测,89例患者未检出耐药突变位点,51例存在治疗前耐药,其中8例低度及以上耐药,43例潜在耐药,且82.4%(42/51)为对EFV和NVP的潜在耐药;检出的耐药突变位点以V179D/E突变为主,占84.3%(43/51),且潜在耐药患者对于非核苷类药物耐药突变位点仅发生V179D/E突变。治疗前不同耐药情况患者抗病毒治疗6个月时的病毒学失败率不同,潜在耐药组最高达86.0%,低度及以上耐药组次之,药物敏感组最低(P<0.05);且潜在耐药组ART 6个月时病毒学失败率显著高于药物敏感组(P=0.006)。结论一线药物治疗失败HIV/AIDS患者以治疗前V179D/E突变造成对EFV和NVP的潜在耐药为主,且这些潜在耐药患者比药物敏感患者抗病毒治疗6个月时的病毒学失败率更高。
Objective To analyze the characteristics of pretreatment genetic drug resistance among HIV/AIDS patients with first-line drug treatment failure(TF).Methods Demographic information,baseline characteristics,and results on drug resistance among patients with the first-line TF who initiated free antiviral treatment in Beijing Ditan hospital from 2014 to 2019 were retrospectively analyzed.Results 140 cases were tested for genetic drug resistance before starting the antiviral therapy.Among them,89 patients did not get tested on the mutation sites of resistance,while 51 patients were tested resistant to drug before the treatment.Of those,including 8 at either low or high level and 43 with potential resistance.82.4%(42/51)of them were potentially resistant to EFV and NVP.The detected mutation site of resistance was mainly V179 D/E(84.3%,43/51),the patients who were potentially resistant to NNRTIs was only detected V179D/E.The virological failure rates were different at six months after antiviral treatment,with 86.0%in the potentially resistant groups and the rest belonged to low or medium or the lowest drug sensitivity groups(P<0.05).The failure rate was significantly higher in the potential resistant group than in the drug-sensitive group(P=0.006).Conclusion The patients with first-line drug treatment failure mainly had pretreatment potential resistance to EFV and NVP caused by V179D/E mutation.The virological failure rate of these patients with potential drug resistance appeared higher than that of drug-sensitive patients after six months of antiviral treatment.
作者
栗翠林
肖静
汪笛
李蓓
刘颖
韩俊燕
赵红心
LI Cuiling;XIAO Jing;WANG Di;LI Bei;LIU Ying;HAN Junyan;ZHAO Hongxin(Peking University Ditan Teaching Hospital,Beijing 100015,China;Beijing Ditan Hospital,Capital Medical University,Beijing 100015)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2021年第5期453-456,共4页
Chinese Journal of Aids & STD
基金
国家“十三五”科技重大专项(2018ZX10715005)
2020年首都卫生发展科研专项项目(2020-2-2174)
北京市医管中心人才培养计划“登峰”项目(DFL20191802)。
关键词
艾滋病病毒
治疗失败
治疗前耐药
潜在耐药
HIV
Treatment failure
Pretreatment drug resistance
Potentially resistant
