Modeling the HIV protease inhibitor adherence-resistance curve by use of empirically derived estimates
Modeling the HIV protease inhibitor adherence-resistance curve by use of empirically derived estimates
复制标题
DOI：
10.1086/420790
复制
发表时间：
2004-07-01
影响因子：
6.4
通讯作者：
Moss, A
中科院分区：
文献类型：
--
作者：
Bangsberg, DR;Porco, TC;Moss, A
标准观点认为，坚持治疗与耐药人类免疫缺陷病毒（HIV）的发展之间存在钟形关系，在中等水平的坚持治疗时出现耐药性高峰。这种关系尚未得到实证证实。我们统计学建模的依从性和耐药性的发展之间的关系，使用经验定义的关系的病毒抑制率和耐药突变的积累来自患者接受蛋白酶抑制剂为基础的治疗。我们发现，最大的耐药率发生在87%的依从性，并在100%的依从性适度下降。在100%依从性下较高水平的病毒抑制（方案效力较高的标志物）逐渐降低总体人群耐药率，并将峰值耐药率转移至较低水平的依从性。
The standard view postulates a bell-shaped relationship between adherence to therapy and development of drug-resistant human immunodeficiency virus (HIV), with a resistance peak at a moderate level of adherence. This relationship has not been confirmed empirically. We statistically modeled the relationship between adherence and development of drug resistance, using empirically defined relationships of the rate of viral suppression and drug-resistance-mutation accumulation derived from patients receiving protease-inhibitor based therapy. We found that the maximal rate of drug resistance occurs at 87% adherence and declines modestly at 100% adherence. Higher levels of viral suppression at 100% adherence (a marker of greater regimen potency) progressively reduce the overall population rate of drug resistance and shift the peak resistance rate to lower levels of adherence.