Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
复制标题
DOI：
10.1097/01.aids.0000433240.78739.30
复制
发表时间：
2013-11-28
期刊：
影响因子：
--
通讯作者：
Hurt CB
中科院分区：
文献类型：
--
作者：
Soeters HM;Napravnik S;Zakharova OM;Eron JJ;Hurt CB
目的：为了评估传播耐药（TDR）的机会，我们研究了性风险行为，艾滋病毒血症和抗逆转录病毒药物耐药的患者在carry.Design：回顾性，横断面分析的临床队列data.Methods：为244艾滋病研究中心艾滋病毒临床队列参与者，人口和行为数据，在2000年和2011年之间的面对面访谈中获得。使用WHO监测耐药突变（SDRM）解释基因型耐药试验。使用对数线性二项回归来评估与TDR风险的相关性，定义为过去6个月内无保护性行为、HIV RNA至少400拷贝/ml和至少一种SDRM。结果：参与者包括91名（37%）女性和153名男性，其中92人（60%）男男性行为者。中位年龄为43岁; 70%为黑人（n= 171）。大多数（97%）是抗逆转录病毒经验; 44%有暴露于四个以上的方案。在204名接受抗逆转录病毒治疗的患者中，42%的患者报告依从性欠佳，29%的患者存在病毒血症。超过一半的参与者至少有一个SDRM（n= 131）; 26（11%）有三级耐药。总体而言，70%的人性活跃，55%的人不经常使用避孕套。30例（12%）报告在耐药病毒血症期间发生无保护性行为。较高的TDR风险与既往无家可归相关[校正的患病率比（aPR）2.20，95%置信区间（CI）1.16-4.18]，活性物质使用（aPR 3.12，95% CI 1.47-6.62），与MSM无显著性差异（aPR 1.75，95% CI 0.93-3.28）。一小部分但很大比例的耐药艾滋病毒临床患者从事性行为，使其他人处于TDR的风险之中。随着时间的推移，二级预防的有针对性的努力可能会对TDR的发生率产生影响。
Objective:To assess opportunities for transmitted drug resistance (TDR), we examined sexual risk behaviours, HIV viraemia and antiretroviral resistance among patients in care.Design:A retrospective, cross-sectional analysis of clinical cohort data.Methods:For 244 UNC Center for AIDS Research HIV Clinical Cohort participants, demographic and behavioural data were obtained during in-person interviews between 2000 and 2011. Genotypic resistance tests were interpreted using WHO surveillance drug resistance mutations (SDRMs). Log-linear binomial regression was used to evaluate associations with TDR risk, defined as unprotected sex in the prior 6 months, HIV RNA at least 400 copies/ml and at least one SDRM.Results:Participants included 91 (37%) women and 153 men, of whom 92 (60%) were MSM. Median age was 43 years; 70% were Black (n= 171). Most (97%) were antiretroviral-experienced; 44% had exposure to more than four regimens. Among 204 individuals on antiretrovirals, 42% reported suboptimal adherence and 29% were viraemic. Over half of participants had at least one SDRM (n= 131); 26 (11%) had triple-class resistance. Overall, 70% were sexually active, and 55% used condoms inconsistently. Thirty (12%) reported unprotected sex during periods of drug-resistant viraemia. Higher TDR risk was associated with prior homelessness [adjusted prevalence ratio (aPR) 2.20, 95% confidence interval (CI) 1.16–4.18], active substance use (aPR 3.12, 95% CI 1.47–6.62) and nonsignificantly with MSM (aPR 1.75, 95% CI 0.93–3.28).Conclusion:A small but significant proportion of clinic patients with drug-resistant HIV engage in sexual behaviours that place others at risk for TDR. Targeted efforts in secondary prevention could have an impact on TDR incidence, over time.
登录
查看更多内容
DOI：
10.1097/qad.0b013e3283121c90
发表时间：
2008-11-30
期刊：
AIDS (London, England)
影响因子：
--
作者：
Brenner BG;Roger M;Moisi DD;Oliveira M;Hardy I;Turgel R;Charest H;Routy JP;Wainberg MA;Montreal PHI Cohort and HIV Prevention Study Groups
通讯作者：
Montreal PHI Cohort and HIV Prevention Study Groups
影响因子：
105.7
作者：
Cane, P;Chrystie, I;Zuckerman, M
通讯作者：
Zuckerman, M
影响因子：
120.7
作者：
Grant, RM;Hecht, FM;Kahn, JO
通讯作者：
Kahn, JO
影响因子：
3.7
作者：
Bennett DE;Camacho RJ;Otelea D;Kuritzkes DR;Fleury H;Kiuchi M;Heneine W;Kantor R;Jordan MR;Schapiro JM;Vandamme AM;Sandstrom P;Boucher CA;van de Vijver D;Rhee SY;Liu TF;Pillay D;Shafer RW
通讯作者：
Shafer RW
影响因子：
3.8
作者：
Kozal, MJ;Amico, KR;Friedland, G
通讯作者：
Friedland, G