Sensitivity and specificity of using CD4+measurement and clinical evaluation to determine antiretroviral treatment failure in Thailand
Sensitivity and specificity of using CD4+measurement and clinical evaluation to determine antiretroviral treatment failure in Thailand
复制标题
DOI：
10.1016/j.ijid.2006.11.003
复制
发表时间：
2007-09-01
影响因子：
8.4
通讯作者：
Supparatpinyo, Khuanchai
中科院分区：
文献类型：
--
作者：
Chaiwarith, Romanee;Wachirakaphan, Charussri;Supparatpinyo, Khuanchai
目的：我们进行了一项研究，评估使用 CD4+ 测量和临床评估来检测接受第一个高效抗逆转录病毒治疗 (HAART) 方案的 HIV 感染患者抗逆转录病毒治疗失败的敏感性和特异性。第二个目标是确定病毒学失败的患病率和危险因素。方法：在泰国清迈大学医院进行了一项回顾性队列研究。进行单变量分析以比较有和没有病毒学失败的患者之间的风险比。使用2×2表格计算免疫学和/或临床标准与病毒学标准相比的敏感性和特异性。结果：从2003年1月到2005年12月，招募了327名HIV感染者。中位随访期为 19 个月（范围 6-42 个月）。 9.2% 的患者检测到病毒学失败。既往有机会性感染史的患者出现病毒学失败的风险更大（OR = 2.66，95% CI = 1.1-6.4）。使用联合免疫学和临床标准来检测抗逆转录病毒治疗失败，敏感性为20.0%，特异性为85.9%。结论：我们的研究由于样本量较小，无法证明免疫学或临床标准可以充分替代病毒学标准来确定治疗失败。 (C) 2006 年国际传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: We conducted a study to evaluate the sensitivity and specificity of using CD4+ measurement and clinical evaluation to detect antiretroviral treatment failure in HIV-infected patients who had received their first regimen of highly active antiretrovirat therapy (HAART). The secondary objective was to determine the prevalence and risk factors of virological failure.Methods: A retrospective cohort study was conducted at Chiang Mai University Hospital, Thailand. Univariate analysis was performed to compare risk ratios between patients with and without virological failure. Sensitivity and specificity of the immunological and/or clinical criteria in comparison with virological criteria were calculated using 2 by 2 tables.Results: From January 2003 to December 2005, 327 HIV-infected patients were enrolled. The median follow-up period was 19 months (range 6-42 months). Virological failure was detected in 9.2% of patients. Patients with a previous history of opportunistic infection had a greater risk for developing virological failure (OR = 2.66, 95% CI = 1.1-6.4). Using the combined immunological and clinical criteria to detect antiretroviral treatment failure, the sensitivity was 20.0% and the specificity was 85.9%.Conclusions: Our study, which was limited by small numbers, was not able to demonstrate that immunological or clinical criteria can adequately replace virological criteria for the determination of treatment failure. (C) 2006 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.