The role of toxicity-related regimen changes in the development of antiretroviral resistance.
The role of toxicity-related regimen changes in the development of antiretroviral resistance.
复制标题
毒性相关的治疗方案改变在抗逆转录病毒耐药性发展中的作用。
DOI：
10.1089/aid.2010.0291
复制
发表时间：
2011
影响因子：
1.5
通讯作者：
Willig,JamesH
中科院分区：
文献类型：
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作者：
Nevin,ChristaR;Ye,Jiatao;Aban,Inmaculada;Mugavero,MichaelJ;Jackson,David;Lin,Hui-Yi;Allison,Jeroan;Raper,JamesL;Saag,MichaelS;Willig,JamesH
In an effort to evaluate factors associated with the development of antiretroviral (ARV) resistance, we assessed the prevalence of toxicity-related regimen changes and modeled its association to the subsequent development of ARV resistance in a cohort of treatment-naive individuals initiating ARV therapy (ART). A retrospective analysis of patients initiating ART was conducted at the UAB 1917 Clinic from 1 January 2000 to 30 September 2007. Cox proportional hazards models were fit to identify factors associated with the development of resistance to ≥1 ARV drug class. Among 462 eligible participants, 14% (n=64) developed ARV resistance. Individuals with ≥1 toxicity-related regimen change (HR=3.94, 95% CI=1.09–14.21), initiating ART containing ddI or d4T (4.12, 1.19–14.26), and from a minority race (2.91, 1.16–7.28) had increased risk of developing resistance. Achieving virologic suppression within 12 months of ART initiation (0.10, 0.05–0.20) and higher pretreatment CD4 count (0.85 per 50 cells/mm3, 0.75–0.96) were associated with decreased hazards of resistance. Changes in ART due to drug intolerance were associated with the subsequent development of ARV resistance. Understanding the role of ARV drug selection and other factors associated with the emergence of ARV resistance will help inform interventions to improve patient care and ensure long-term treatment success.
