摘要
目的 分析云南省以含整合酶抑制剂(INSTI)方案启动cART疗效,以指导INSTI在初治患者中的应用。方法 采用回顾性队列研究方法。基于国家艾滋病防治基本信息系统,纳入2019年1月至2024年7月在云南省108家cART定点医院启动且治疗满12个月的HIV/AIDS患者,按启动治疗方案是否含INSTI,分为INSTI组与非INSTI组。采用泊松回归分析两组在治疗12个月时的治疗保持率、病死率和病毒抑制率是否有差别。结果 共纳入32 991例HIV/AIDS患者,其中INSTI组1 453例(4.4%),非INSTI组31 538例(95.6%)。两组患者的基线CD4细胞计数、启动治疗医院级别、性别、传播途径、受教育程度、民族、职业、年龄、从发现到启动治疗间隔天数和启动治疗年份差异有统计学意义。INSTI组在治疗12个月治疗保持率、病死率和病毒抑制率分别为90.5%、6.4%和96.4%,非INSTI组分别为92.7%、3.2%和92.4%。泊松回归结果显示,两组患者在治疗12个月时的治疗保持率和病毒抑制率差异无统计学意义,INSTI组12个月病死风险是非INSTI组的1.78倍(95%CI:1.41~2.25)。结论 云南省启动cART的患者中无论启动方案是否含INSTI,12个月时的治疗保持和病毒抑制情况无差异。
Objective To analyze the effectiveness of initiating combination antiretroviral therapy(cART)with integrase strand transfer inhibitor(INSTI)based regimens in Yunnan Province to guide the application of INSTIs in treatment-naive patients.Methods A retrospective cohort study was conducted.Based on the National AIDS Prevention and Control Information System,patients with HIV/AIDS who initiated cART and completed 12 months of treatment between January 2019 and July 2024 at 108 designated cART hospitals in Yunnan Province were enrolled.Patients were divided into INSTI and non-INSTI groups according to whether their initial treatment regimen included an INSTI.Poisson regression analysis was used to assess differences between the two groups in terms of treatment retention,mortality,and viral suppression rates after 12 months of treatment.Results A total of 32991 patients with HIV/AIDS were included,of whom 1453(4.4%)were in the INSTI group and 31538(95.6%)were in the non-INSTI group.Statistically significant differences were observed between the two groups in terms of baseline CD4 cell count,hospital level at treatment initiation,sex,transmission route,education level,ethnicity,occupation,age,time interval from diagnosis to treatment initiation,and year of treatment initiation.After 12 months of treatment,the treatment retention,mortality,and viral suppression rates were 90.5%,6.4%,and 96.4%respectively,in the INSTI group,compared to 92.7%,3.2%,and 92.4%respectively,in the non-INSTI group.Poisson regression results showed no statistically significant difference between the two groups in terms of treatment retention and viral suppression rates after 12 months.However,patients in the INSTI group had a 1.78-fold higher risk of death after 12 months than those in the non-INSTI group(95%confidence interval:1.41-2.25).Conclusions Among patients initiating cART in Yunnan,there was no difference in treatment retention or viral suppression after 12 months between those who started treatment with or without INSTI.
作者
安靓
劳云飞
楼金成
辛佳盈
陶鹏飞
杨根
王林
AN Jing;LAO Yunfei;LOU Jincheng;XIN Jiaying;TAO Pengfei;YANG Gen;WANG Lin(Yunnan Infectious Diseases Hospital/Yunnan AIDS Care Center,Kunming 650301,Yunnan,China)
出处
《中国艾滋病性病》
北大核心
2025年第7期730-736,共7页
Chinese Journal of Aids & STD
关键词
整合酶抑制剂
启动
艾滋病抗病毒治疗
疗效
anti-retroviral therapy
integrase strand transfer inhibitor
implementation
efficacy
