The prevalence of antiretroviral drug resistance in the United States
The prevalence of antiretroviral drug resistance in the United States
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DOI：
10.1097/01.aids.0000131310.52526.c7
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发表时间：
2004-07-02
期刊：
影响因子：
3.8
通讯作者：
Bozzette, SA
中科院分区：
文献类型：
--
作者：
Richman, DD;Morton, SC;Bozzette, SA
背景：抗逆转录病毒治疗显着降低了艾滋病毒感染的发病率和死亡率。耐药病毒的出现限制了许多药物的用途。 目的：确定在美国接受护理的成年人群中 HIV 耐药性的流行情况。设计和方法：对代表 132500 名 HIV 感染美国成年人的血浆病毒进行血浆病毒药物敏感性测定，这些成年人在 1996 年初接受过医疗护理，但病毒血症的病毒浓度 > 500 拷贝/ml。 1998 年底的 HIV RNA。从 1797 名患者中获取了血液样本，这些患者是 1996 年初因感染 HIV 接受城市护理的 208900 名成年人的代表性样本，他们存活到 1998 年底。抽样程序允许对每位评估患者进行加权，以反映目标人群的人口统计和其他特征。结果：我们估计目标人群中有 132 500 人 (63%) 的 HIV 病毒血症> 500 份数/毫升。在病毒血症患者中，估计 76% 对一种或多种抗逆转录病毒药物具有耐药性。根据自我报告，有抗逆转录病毒药物使用史、晚期 HIV 疾病、血浆 HIV 病毒载量较高和 CD4 细胞计数最低的患者的耐药几率显着较高。结论：在广泛使用强效抗逆转录病毒联合疗法的前 3 年中，病毒血症患者中频繁选择耐药病毒，这对 HIV 治疗和传播具有重要意义。(C) 2004 Lippincott Williams Wilkins。
Background: Antiretroviral therapy has dramatically reduced the morbidity and mortality of infection due to HIV. The emergence of drug-resistant virus has limited the usefulness of many drugs.Objective: To determine the prevalence of HIV drug resistance in the population of adults receiving care in the United States.Design and methods: HIV drug susceptibility assays were performed on plasma virus from a random sample representative of the 132500 HIV-infected American adults who had received medical care in early 1996 yet were viremic with > 500 copies/ml of HIV RNA in late 1998. A blood sample was obtained from 1797 patients who comprised a representative sample of the 208900 adults receiving urban care for HIV infection in early 1996 who survived to late 1998. The sampling procedure permitted weighting each evaluated patient to reflect demographic and other characteristics of the target population.Results: We estimated that 132 500 (63%) of the target population had HIV viremia of > 500 copies/ml. Among viremic patients, an estimated 76% had resistance to one or more antiretroviral drugs. The odds of resistance were significantly higher in patients with a history of antiretroviral drug use, advanced HIV disease, higher plasma HIV viral load and lowest CD4 cell count by self-report. Conclusions: The frequent selection for drug-resistant virus among viremic patients during the first 3 years of widespread use of potent antiretroviral combination therapy has significant implications for HIV treatment and transmission.(C) 2004 Lippincott Williams Wilkins.