Emerging of HIV Drug Resistance: Epidemiology, Diagnosis, Treatment and Prevention
Emerging of HIV Drug Resistance: Epidemiology, Diagnosis, Treatment and Prevention
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DOI：
10.2174/157016209788347976
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发表时间：
2009-05-01
影响因子：
1
通讯作者：
Sungkanuparph, Somnuek
中科院分区：
文献类型：
--
作者：
Kiertiburanakul, Sasisopin;Sungkanuparph, Somnuek
艾滋病毒/艾滋病患者抗逆转录病毒治疗在全球范围内使用，包括在资源有限的环境中。并不总是观察到成功的结果，艾滋病毒对抗逆转录病毒药物的耐药性是治疗失败的主要原因。原发性和继发性耐药已在世界范围内得到描述和报道。原发性耐药可能意味着个体感染了耐药病毒，而继发性耐药通常意味着治疗失败的结果。每一类抗逆转录病毒药物的耐药发病机制不同，取决于药物的作用机制。诊断治疗失败和HIV耐药的三个主要实验室检查是HIV RNA水平、CD4细胞计数和HIV耐药检测。探讨了HIV耐药患者的管理理念。预防艾滋病毒耐药性出现的战略包括发现急性艾滋病毒感染病例，早期发现病毒学失败，以及行为干预，如坚持治疗和使用避孕套。
Antiretroviral therapy for HIV/AIDS patients are used globally including in resource-limited settings. Successful outcomes are not always observed and HIV resistance to antiretroviral agents is a major cause of treatment failure. Both primary and secondary drug resistance have been described and reported worldwide. Primary resistance, which presumably means that individuals are infected with drug-resistant virus and secondary resistance typically, means a result of treatment failure. Pathogenesis of resistance of each antiretroviral drugs class differs and depends on the mechanism of action of the drugs. Three main laboratory investigations for diagnosis of treatment failure and HIV drug resistance are HIV RNA level, CD4 cell count, and HIV resistance testing. Management concepts for patients with HIV drug resistance are discussed. Strategies for prevention of HIV resistance emergence include finding cases with acute HIV infection, early detection of virological failure, and behavioral interventions such as adherence and condom usage.