Time trends in primary resistance to HIV drugs in the United Kingdom: multicentre observational study
Time trends in primary resistance to HIV drugs in the United Kingdom: multicentre observational study
复制标题
DOI：
10.1136/bmj.38665.534595.55
复制
发表时间：
2005-12-10
影响因子：
105.7
通讯作者：
Zuckerman, M
中科院分区：
文献类型：
--
作者：
Cane, P;Chrystie, I;Zuckerman, M
目的探讨英国艾滋病病毒（HIV）耐药水平是否正在上升。设计多中心观察性研究。研究对象为英国所有进行HIV耐药检测的病毒学实验室，作为常规临床护理的一部分。参与者为2357名在接受抗逆转录病毒治疗前进行耐药检测的HIV感染者。主要结果指标基于抗逆转录病毒治疗的HIV耐药流行率。研究对象为2357名接受抗逆转录病毒治疗的HIV感染者。研究对象为2357名接受抗逆转录病毒治疗前进行耐药检测的HIV感染者。主要结果指标为2357名接受抗逆转录病毒治疗的HIV感染者。研究对象为2结果在1996年2月至2003年5月的研究期间，335例（14.2%，95%可信区间为12.8%~ 15.7%）样本存在对一种或多种抗逆转录病毒药物产生耐药的突变（9.3%高度耐药，5.9%中度耐药）。原发性耐药的发生率随着时间的推移而显著增加，尽管模式是特定于药物类别的;最大的增加是非核苷类逆转录酶抑制剂。2002- 2003年，对任何抗逆转录病毒药物、核苷或核苷酸逆转录酶抑制剂、非核苷逆转录酶抑制剂和蛋白酶抑制剂的耐药率为19.2%（15.7%~ 23.2%）、12.4%（9.5%~ 15.9%）、8.1%（5.8%~ 11.1%）、6.6%（4.4%~ 9.3%）。原发性耐药的风险只有弱相关的大多数人口和临床因素，包括种族和病毒subtype.Conclusions英国有一个最高的报告率的原发性耐药艾滋病毒药物的全球范围内。流行率似乎仍在上升，在所有人口分组中都很高。
Objective To examine whether the level of primary resistance to HIV drugs is increasing in the United Kingdom.Design Multicentre observational study.Setting All virology laboratories in the United Kingdom carrying out tests for HIV resistance as part Of routine clinical care.Participants 2357 people infected with HIV who were tested for resistance before receiving antiretroviral therapy.Main outcome measure Prevalence of drug resistance on basis of the Stanford genotypic interpretation system.Results Over the study period (February 1996 to May 2003),335 (14.2%,95% confidence interval 12.8% to 15.7%) samples had mutations that conferred resistance to one or more antiretroviral drugs (9.3% high level resistance, 5.9% medium level resistance). The prevalence of primary resistance has increased markedly over time, although patterns are specific to drug class; the largest increase was for non-nucleoside reverse transcriptase inhibitors. In 2002-3, the prevalence of resistance to any antiretroviral drug, to nucleoside or nucleotide reverse transcriptase inhibitors, to non-nucleoside reverse transcriptase inhibitors, or to protease inhibitors Was 19.2% (15.7% to 23.2%),12.4% (9.5% to 15.9%),8.1% (5.8% to 11.1%), and 6.6% (4.4% to 9.3% respectively. The risk of primary resistance was only Weakly related to most demographic and clinical factors, including ethnicity and viral subtype.Conclusions The United Kingdom has one of the highest reported rates of primary resistance to HIV drugs worldwide. Prevalence seems still to be increasing and is high in all demographic subgroups.