Preexisting resistance to nonnucleoside reverse-transcriptase inhibitors predicts virologic failure of an efavirenz-based regimen in treatment-naive HIV-1-infected subjects
Preexisting resistance to nonnucleoside reverse-transcriptase inhibitors predicts virologic failure of an efavirenz-based regimen in treatment-naive HIV-1-infected subjects
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DOI：
10.1086/528802
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发表时间：
2008-03-15
影响因子：
6.4
通讯作者：
Gulick, Roy M.
中科院分区：
文献类型：
--
作者：
Kuritzkes, Daniel R.;Lalama, Christina M.;Gulick, Roy M.
在艾滋病临床试验组A5095中，采用病例队列研究确定基线非核苷类逆转录酶抑制剂（NNRTI）耐药（通过病毒基因分型评估）对含依法韦仑方案应答的影响。样本包括一个随机队列的依法韦仑治疗的受试者加上受试者谁经历了病毒学失败。在随机队列的220例受试者中，57例（26%）病毒学失败。基线NNRTI耐药的患病率为5%。基线NNRTI耐药受试者的病毒学失败风险高于无耐药受试者（风险比2.27 [95%置信区间]，1.15-4.49; P = 0.018）。这些结果支持在开始抗逆转录病毒治疗前进行耐药性检测。
A case-cohort study was used to determine the effect of baseline nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance, as assessed by viral genotyping, on the response to efavirenz-containing regimens in AIDS Clinical Trials Group A5095. The sample included a random cohort of efavirenz-treated subjects plus unselected subjects who experienced virologic failure. Of 220 subjects in the random cohort, 57 (26%) had virologic failure. The prevalence of baseline NNRTI resistance was 5%. The risk of virologic failure for subjects with baseline NNRTI resistance was higher than that for subjects without such resistance (hazard ratio 2.27 [95% confidence interval], 1.15-4.49; P = .018). These results support resistance testing before starting antiretroviral therapy.