Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study
Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study
复制标题
DOI：
10.1136/sextrans-2018-053854
复制
发表时间：
2019-09-01
影响因子：
3.6
通讯作者：
Seeley, Janet
中科院分区：
文献类型：
--
作者：
Namale, Gertrude;Kamacooko, Onesmus;Seeley, Janet
目的：我们评估了乌干达坎帕拉接受抗逆转录病毒治疗（ART）的女性性工作者中病毒学失败的患病率和风险因素。方法：我们在2015年1月至2016年12月期间进行了一项横断面研究，使用在一家研究诊所常规收集的数据，该诊所为包括艾滋病毒在内的性传播感染高危女性提供服务。对接受抗逆转录病毒治疗至少6个月并接受了依从性咨询的≥ 18岁艾滋病毒血清反应阳性妇女的血浆样本进行病毒载量检测。病毒学失败（>= 1000拷贝/mL）的女性样本通过基于人群的测序检测HIV耐药性。我们使用逻辑回归来确定与病毒学失败相关的因素。结果在584名妇女中，432名（74%），平均年龄为32岁（SD 6.5）进行了评估，38名（9%）被发现有病毒学失败。78%（28/38）的患者进行了HIV耐药检测，其中82.1%（23/28）至少有一个主要耐药突变（DRM），最常见的是M184 V（70%，16/23）和K103 N（65%，15/23）。在多变量分析中，病毒学失败与受试者年龄18-24岁（校正OR（aOR）=5.3，95%CI 1.6 - 17.9）、自我报告的ART不依从性（aOR=2.6，95%CI 1.2 - 5.8）和基线CD 4 + T细胞计数相关
Objectives We assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART) in Kampala, Uganda. Methods We conducted a cross-sectional study between January 2015 and December 2016 using routinely collected data at a research clinic providing services to women at high risk of STIs including HIV. Plasma samples were tested for viral load from HIV-seropositive women aged >= 18 years who had been on ART for at least 6 months and had received adherence counselling. Samples from women with virological failure (>= 1000 copies/mL) were tested for HIV drug resistance by population-based sequencing. We used logistic regression to identify factors associated with virological failure. Results Of 584 women, 432 (74%) with a mean age of 32 (SD 6.5) were assessed, and 38 (9%) were found to have virological failure. HIV resistance testing was available for 78% (28/38), of whom 82.1% (23/28) had at least one major drug resistance mutation (DRM), most frequently M184V (70%, 16/23) and K103N (65%, 15/23). In multivariable analysis, virological failure was associated with participant age 18-24 (adjusted OR (aOR)=5.3, 95% CI 1.6 to 17.9), self-reported ART non-adherence (aOR=2.6, 95% CI 1.2 to 5.8) and baseline CD4+ T-cell count