Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV-1 Shedding among Women Initiating Treatment
Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV-1 Shedding among Women Initiating Treatment
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DOI：
10.1086/656790
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发表时间：
2010-11-15
影响因子：
6.4
通讯作者：
McClelland, R. Scott
中科院分区：
文献类型：
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作者：
Graham, Susan M.;Masese, Linnet;McClelland, R. Scott
在接受抗逆转录病毒治疗的妇女中，持续的生殖器人类免疫缺陷病毒1型（HIV-1）脱落可能存在传播风险。我们调查了ART启动后生殖器HIV-1抑制与依从性、耐药性、治疗前CD 4细胞计数和激素避孕药使用之间的关系。在102名妇女中启动了一线抗逆转录病毒疗法。在第0、3和6个月测量血浆和生殖器HIV-1 RNA水平。依从性是生殖道HIV-1抑制的一个强有力且一致的预测因素（P <0.001），而基因型耐药与6个月时阴道HIV-1 RNA水平较高相关（P <0.001）。04）。这些结果强调了坚持使用抗逆转录病毒疗法以优化其潜在益处以降低HIV-1传播风险的重要性。
Persistent genital human immunodeficiency virus type 1 (HIV-1) shedding among women receiving antiretroviral therapy (ART) may present a transmission risk. We investigated the associations between genital HIV-1 suppression after ART initiation and adherence, resistance, pretreatment CD4 cell count, and hormonal contraceptive use. First-line ART was initiated in 102 women. Plasma and genital HIV-1 RNA levels were measured at months 0, 3, and 6. Adherence was a strong and consistent predictor of genital HIV-1 suppression (P < .001), whereas genotypic resistance was associated with higher vaginal HIV-1 RNA level at month 6 (Pp. 04). These results emphasize the importance of adherence to optimize the potential benefits of ART for reducing HIV-1 transmission risk.