Predictive Factors of High-Risk Events for Virological Failure in HIV/AIDS Patients Receiving Long-Term Antiviral Therapy
Predictive Factors of High-Risk Events for Virological Failure in HIV/AIDS Patients Receiving Long-Term Antiviral Therapy
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接受长期抗病毒治疗的艾滋病毒/艾滋病患者病毒学失败高风险事件的预测因素
DOI：
10.21203/rs.3.rs-153807/v1
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Chuanyi Ning
中科院分区：
文献类型：
--
作者：
Shanfang Qin;Jingzhen Lai;Hong Zhang;Di Wei;Qing Lv;Xue Pan;Lihua Huang;Ke Lan;Zhihao Meng;Hao Liang;Chuanyi Ning
背景：在抗逆转录病毒治疗（ART）时代，血浆HIV病毒载量（VL）是监测HIV治疗反应的重要首要指标。为了优化HIV/AIDS患者的临床管理，我们对病毒学失败（VF）相关的VL高危事件进行了调查，并进一步探讨了高危事件的预防因素。方法：数据来源于中国艾滋病综合防治信息管理系统。纳入2003年至2019年在广西开始或接受ART的HIV患者。通过 Kaplan-Meier 曲线、对数秩检验和 Cox 回归分析，分析了 ART 6 个月后 VL 对 VF 和 AIDS 相关死亡的贡献。采用描述性分析和双因素logistic回归进一步探讨与VF高危事件相关的预防因素。结果：高低水平病毒血症组（χ2 = 18.45；P < 0.001）和非抑制组（χ2 = 82.99；P < 0.001）VF累积发生率显着高于病毒抑制（VS）组。与VS组相比，高LLV组的调整后危险风险为7.221（95% CI：2.668；19.547），非抑制组为8.351（95% CI：4.253；16.398）。与单身患者相比，已婚或同居（AOR = 0.591；95% CI：0.408，0.856）和离婚或分居（AOR = 0.425，95% CI：0.207，0.873）患者与高风险事件呈负相关。同性恋感染 HIV 的患者也是如此（AOR = 0.572；95% CI：0.335，0.978）。然而，接受 ART 改良的患者发生高风险事件的可能性增加 1.728 倍 (95% CI: 1.093, 2.732)，而在 ART 期间使用复方新诺明的患者发生高风险事件的可能性增加 1.843 倍 (95% CI: 1.271, 2.672)。 结论：VL 大于 200 拷贝/ml 是高风险事件室颤。应采取干预措施来优化对单身或丧偶、接受 ART 改良以及在 ART 期间使用复方新诺明的患者的 ART 监测。
Background: In the era of anti-retroviral therapy (ART), the plasma HIV viral load (VL) is an important primary indicator for monitoring the HIV treatment response. To optimize the clinical management of HIV/AIDS patients, we investigated VL high-risk events related to virological failure (VF) and further explored the preventive factors of high-risk events.Methods: The data were derived from China’s HIV/AIDS Comprehensive Response Information Management System. HIV patients who initiated or received ART in Guangxi between 2003 and 2019 were included. The contributions of VL after 6 months of ART to VF and AIDS-related death were analysed by Kaplan-Meier curves, log-rank tests and Cox regression analyses. Both descriptive analyses and bivariate logistic regression were employed to further explore the preventive factors related to high-risk events of VF.Results: The cumulative rates of VF in the high low-level viremia group (χ2 = 18.45; P < 0.001) and non-suppressed group (χ2 = 82.99; P < 0.001) were significantly higher than those in the viral suppression (VS) group. Compared with the VS group, the adjusted hazard risk was 7.221 (95% CI: 2.668; 19.547) in the high LLV group and 8.351 (95% CI: 4.253; 16.398) in the non-suppressed group. Compared with single patients, married or cohabiting (AOR = 0.591; 95% CI: 0.408, 0.856) and divorced or separated (AOR = 0.425, 95% CI: 0.207, 0.873) patients were negatively associated with high-risk events. So were patients acquired HIV homosexually (AOR = 0.572; 95% CI: 0.335, 0.978). However, patients who had ART modification were 1.728 times (95% CI: 1.093, 2.732) more likely to have high-risk events, and patients who used cotrimoxazole during ART were 1.843 times (95% CI: 1.271, 2.672) more likely to have high-risk events.Conclusions: A VL greater than 200 copies/ml is a high-risk event for VF. Intervention measurements should be adopted to optimize the surveillance of ART in patients who are single or widowed, who have ART modification, and who use cotrimoxazole during ART.
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影响因子：
15.8
作者：
Keiser O;Orrell C;Egger M;Wood R;Brinkhof MW;Furrer H;van Cutsem G;Ledergerber B;Boulle A;Swiss HIV Cohort Study (SHCS) and the International Epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA)
通讯作者：
Swiss HIV Cohort Study (SHCS) and the International Epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA)
影响因子：
6
作者：
Haas AD;Radin E;Hakim AJ;Jahn A;Philip NM;Jonnalagadda S;Saito S;Low A;Patel H;Schwitters AM;Rogers JH;Frederix K;Kim E;Bello G;Williams DB;Parekh B;Sachathep K;Barradas DT;Kalua T;Birhanu S;Musuka G;Mugurungi O;Tippett Barr BA;Sleeman K;Mulenga LB;Thin K;Ao TT;Brown K;Voetsch AC;Justman JE
通讯作者：
Justman JE
DOI：
10.1056/nejmoa1600693
发表时间：
2016-09-01
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen MS;Chen YQ;McCauley M;Gamble T;Hosseinipour MC;Kumarasamy N;Hakim JG;Kumwenda J;Grinsztejn B;Pilotto JH;Godbole SV;Chariyalertsak S;Santos BR;Mayer KH;Hoffman IF;Eshleman SH;Piwowar-Manning E;Cottle L;Zhang XC;Makhema J;Mills LA;Panchia R;Faesen S;Eron J;Gallant J;Havlir D;Swindells S;Elharrar V;Burns D;Taha TE;Nielsen-Saines K;Celentano DD;Essex M;Hudelson SE;Redd AD;Fleming TR;HPTN 052 Study Team
通讯作者：
HPTN 052 Study Team
影响因子：
120.7
作者：
Gunthard, Huldrych F.;Saag, Michael S.;Benson, Constance A.;del Rio, Carlos;Eron, Joseph J.;Gallant, Joel E.;Hoy, Jennifer F.;Mugavero, Michael J.;Sax, Paul E.;Thompson, Melanie A.;Gandhi, Rajesh T.;Landovitz, Raphael J.;Smith, Davey M.;Jacobsen, Donna M.;Volberding, Paul A.
通讯作者：
Volberding, Paul A.
影响因子：
3.8
作者：
Lodwick, Rebecca K.;Smith, Colette J.;Phillips, Andrew N.
通讯作者：
Phillips, Andrew N.