Antiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real-life situation in 2002
Antiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real-life situation in 2002
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DOI：
10.1111/j.1468-1293.2005.00338.x
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发表时间：
2006-01-01
期刊：
影响因子：
3
通讯作者：
Arendt, V
中科院分区：
文献类型：
--
作者：
Fischer, A;Karasi, JC;Arendt, V
我们的研究旨在通过描述卢旺达在启动一项大型抗逆转录病毒治疗计划之前的基线情况来完成非洲抗逆转录病毒治疗的已发表数据（ESTHER）。分析了卢旺达现有病毒的处方习惯、中断治疗的频率和原因，以及抗病毒药物的有效性、对抗逆转录病毒药物的耐药性和基因型变异性。在纳入研究的233名患者中，似乎绝大多数（91%）正在接受三联治疗，其中一半的患者至少经历过一次主要由药物短缺或经济困难引起的治疗中断。在分析的60份血样中，26份病毒载量超过1000 RNA拷贝/ml，出现病毒学失败，11份出现主要耐药突变。最后，病毒学失败的主要原因是治疗中断的频率高，但也可能是耐药性突变的出现。因此，以斯帖方案改善卢旺达局势的主要目标将是减少药物短缺和促进治疗的财政可及性。
Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency and reasons for treatment interruptions but also antiviral efficay, resistance to ARVs and genotypic variability of the viruses present in Rwanda were analysed. Among the 233 patients included in the study, it appeared that a vast majority (91%) were under triple therapy and that half of them had experienced at least one treatment interruption caused mainly by drug shortage or financial difficulties. Among 60 blood samples analysed, 26 were in virological failure with a viral load above 1000 RNA copies/ml and 11 presented major drug resistance mutations.Finally, virological failure could mainly be explained by the high frequency of treatment interruptions but also by the emergence of drug resistance mutations. Consequently the major objective for the ESTHER programme to improve the situation in Rwanda will be to reduce the drug shortage and facilitate the financial accessibility of the treatments.