Increased risk of virologic rebound in patients on antiviral therapy with a detectable HIV load <48 copies/mL.
Increased risk of virologic rebound in patients on antiviral therapy with a detectable HIV load <48 copies/mL.
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可检测的HIV负荷<48份/mL的抗病毒治疗患者的病毒学反弹风险增加。
DOI：
10.1371/journal.pone.0050065
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Kuritzkes DR
中科院分区：
文献类型：
--
作者：
Henrich TJ;Wood BR;Kuritzkes DR
我们研究了HIV-1“未检测目标”测量与Taqman RT-PCR检测可检测但低于定量限制的测量对随后病毒反弹的独立影响，因为关于任意或分离的低水平病毒血症的临床意义存在相互矛盾的数据。采用Cox比例风险回归模型，对所有患者和倾向匹配基线队列进行分析，研究引入Taqman RT-PCR检测（时间点0 [T0]）后的首次HIV-1载量测量、T0前病毒载量、CD4 T细胞计数、种族/民族、性别、年龄和使用NNRTI对22个月随访时确诊VL bbb50、>00、bbb400和>000拷贝/mL风险的独立影响。778例患者的病毒载量在T0时未被RT-PCR检测到（N = 596）或可检测到，但低于定量限（N = 182）。可检测到的病毒血症、较低的T0 CD4计数、年龄下降以及T0前一年内可检测到或未知的VL均与病毒反弹至bbb50、>00和bbb400拷贝/mL相关。总体失败率低，小于5.5%的患者确认VL为1000拷贝/mL。大多数反弹bbb200拷贝/mL的患者随后再次抑制（53例中有28例）。可检测到的VL <48拷贝/mL与随后的病毒反弹独立且显著相关，是引起临床关注的原因。
We investigated the independent effects of HIV-1 ”target not detected” measurements versus those that were detectable but below the limit of quantification by Taqman RT-PCR assay on subsequent viral rebound as there are conflicting data regarding the clinical implications of arbitrary or isolated low-level viremia. Cox proportional hazard regression modeling was used to investigate the independent effects of the first HIV-1 load measurement after introduction of the Taqman RT-PCR assay (time-point 0 [T0]), pre-T0 viral loads, CD4 T cell count, race/ethnicity, gender, age and NNRTI use on risk of a confirmed VL >50, >200, >400 and >1000 copies/mL at 22 months follow-up in analyses of all patients and propensity-matched baseline cohorts. 778 patients had a viral load that was either not detected by RT-PCR (N = 596) or detectable, but below the limit of quantification (N = 182) at T0. Detectable viremia, lower T0 CD4 count, decreased age, and having detectable or unknown VL within a year prior to T0 were each associated with viral rebound to >50, >200 and >400 copies/mL. Overall failure rates were low and <5.5% of all patients had confirmed VL >1000 copies/mL. A majority of patients with rebound >200 copies/mL subsequently re-suppressed (28 of 53). A detectable VL <48 copies/mL was independently and significantly associated with subsequent viral rebound, and is cause for clinical concern.
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影响因子：
9.4
作者：
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