Virologic outcomes of first-line HAART and associated factors among Chinese patients with HIV in three sentinel antiretroviral treatment sites
Virologic outcomes of first-line HAART and associated factors among Chinese patients with HIV in three sentinel antiretroviral treatment sites
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DOI：
10.1111/j.1365-3156.2010.02621.x
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发表时间：
2010-11-01
影响因子：
3.3
通讯作者：
Shao, Yiming
中科院分区：
文献类型：
--
作者：
Ruan, Yuhua;Xing, Hui;Shao, Yiming
目的了解中国HIV感染者接受一线高效抗逆转录病毒治疗（HAART）后的耐药情况。对341名既往未接受过抗逆转录病毒治疗（ART）的受试者进行前瞻性队列研究，随访12个月，以评估HIV RNA < 1000拷贝/ml和HIV DR的患病率。平均随访12.1个月。总体死亡率为每100人年9.9人。CD 4计数的中位数从基线时的182个细胞/mm（3）增加到12个月时的268个细胞/mm（3）（P < 0.0001）。在12个月时血浆HIV-1 RNA浓度≥ 1000拷贝/ml的患者中，对非核苷类逆转录酶药物、核苷/核苷酸类逆转录酶抑制剂和蛋白酶抑制剂药物的耐药比例分别为34.2%、23.7%和0%。12个月时HIV RNA < 1000拷贝/ml的总体比例为85.7%。农民职业（AOR = 0.3，95% CI：0.08，0.94; P = 0.0393）和通过电话进行HAART咨询和指导（AOR = 2.8，95% CI：1.4，5.6; P = 0.0047）与HIV RNA < 1000拷贝/ml显著相关。基础抗逆转录病毒治疗对病毒抑制和免疫恢复有显著效果。应长期监测艾滋病毒/艾滋病，以指导关于预防艾滋病毒/艾滋病的知情决定以及一线和二线治疗方案的选择。
OBJECTIVE To evaluate HIV drug resistance (HIVDR) among Chinese patients with HIV receiving first-line highly active antiretroviral therapy (HAART).METHODS Based on the WHO HIVDR surveys, a prospective cohort study with 12-month follow-up was conducted to estimate the prevalence of HIV RNA < 1000 copies/ml and HIVDR.RESULTS A total of 341 study subjects naive to prior antiretroviral therapy (ART) were followed up for a median of 12.1 months. The overall mortality rate was 9.9 per 100 person-years. The median of CD4 counts increased from 182 cells/mm(3) at baseline to 268 cells/mm(3) at 12 months (P < 0.0001). Of patients with plasma HIV-1 RNA concentrations >= 1000 copies/ml at 12 months, the proportions of resistance to non-nucleoside reverse transcriptase drugs, nucleoside/nucleotide reverse transcriptase inhibitors, and protease inhibitor drugs were 34.2%, 23.7% and 0%, respectively. The overall proportion of HIV RNA < 1000 copies/ml was 85.7% at 12 months. Occupation of farmer (AOR = 0.3, 95% CI: 0.08, 0.94; P = 0.0393) and HAART counselling and instruction through telephone (AOR = 2.8, 95% CI: 1.4, 5.6; P = 0.0047) were significantly associated with HIV RNA < 1000 copies/ml.CONCLUSION Our study demonstrated that the community-based ART had significant effects on viral suppression and immune recovery. HIVDR should be monitored in the long term to guide informed decisions on preventing HIVDR and choices of first- and second-line regimens.