Predictive factors of viral load high-risk events for virological failure in HIV/AIDS patients receiving long-term antiviral therapy.
Predictive factors of viral load high-risk events for virological failure in HIV/AIDS patients receiving long-term antiviral therapy.
复制标题
接受长期抗病毒治疗的艾滋病毒/艾滋病患者病毒学失败的病毒载量高风险事件的预测因素。
DOI：
10.1186/s12879-021-06162-z
复制
发表时间：
2021-05-18
影响因子：
3.7
通讯作者：
Ning C
中科院分区：
文献类型：
--
作者：
Qin S;Lai J;Zhang H;Wei D;Lv Q;Pan X;Huang L;Lan K;Meng Z;Liang H;Ning C
在抗逆转录病毒治疗（ART）时代，血浆HIV病毒载量（VL）是监测HIV治疗反应的重要主要指标。为了优化HIV/AIDS患者的临床管理，我们调查了与病毒学失败（VF）相关的VL高危事件，并进一步探讨VL高危事件的预防因素。这些数据来自中国艾滋病综合应对信息管理系统。纳入了2003年至2019年期间在广西开始或接受ART的HIV感染者。采用Kaplan-Meier曲线、对数秩检验和考克斯回归分析分析ART治疗6个月后VL对VF和AIDS相关死亡的贡献。采用描述性分析和双变量Logistic回归分析进一步探讨VL高危VF事件的相关预防因素。高低水平病毒血症组（高LLV组）和未抑制组（χ 2 = 82.99; P <0.001）的VF累积发生率均显著高于病毒抑制组（VS组）。因此，VF的VL高危事件定义为ART治疗6个月后最高VL > 200拷贝/ml。与VS组相比，高LLV组的校正危险风险为7.221（95%CI：2.668; 19.547），非抑制组为8.351（95%CI：4.253; 16.398）。与单身患者相比，已婚或同居（AOR = 0.591; 95% CI：0.408，0.856）和离婚或分居（AOR = 0.425，95% CI：0.207，0.873）患者与VL高危事件呈负相关。同性性接触感染者也是如此（AOR = 0.572; 95% CI：0.335，0.978）。然而，接受ART调整的患者发生VL高危事件的可能性是其他患者的1.728倍（95%CI：1.093，2.732），ART期间使用复方新诺明的患者发生VL高危事件的可能性是其他患者的1.843倍（95%CI：1.271，2.672）。VL大于200拷贝/ml是VF的VL高风险事件。应采取干预措施，以优化对单身或丧偶患者、ART修改患者和ART期间使用复方新诺明患者的ART监测。
In the era of anti-retroviral therapy (ART), the plasma HIV viral load (VL) is an important primary indicator for monitoring the HIV treatment response. To optimize the clinical management of HIV/AIDS patients, we investigated VL high-risk events related to virological failure (VF) and further explored the preventive factors of VL high-risk events. The data were derived from China’s HIV/AIDS Comprehensive Response Information Management System. HIV infected patients who initiated or received ART in Guangxi between 2003 and 2019 were included. The contributions of VL after 6 months of ART to VF and AIDS-related death were analysed by Kaplan-Meier curves, log-rank tests and Cox regression analyses. Both descriptive analyses and bivariate logistic regression were employed to further explore the preventive factors related to VL high-risk events of VF. The cumulative rates of VF in the high low-level viremia group (high LLV) (χ2 = 18.45; P < 0.001) and non-suppressed group (χ2 = 82.99; P < 0.001) were significantly higher than those in the viral suppression (VS) group. Therefore, the VL high-risk events of VF was defined as highest VL > 200 copies/ml after 6 months of ART. Compared with the VS group, the adjusted hazard risk was 7.221 (95% CI: 2.668; 19.547) in the high LLV group and 8.351 (95% CI: 4.253; 16.398) in the non-suppressed group. Compared with single patients, married or cohabiting (AOR = 0.591; 95% CI: 0.408, 0.856) and divorced or separated (AOR = 0.425, 95% CI: 0.207, 0.873) patients were negatively associated with VL high-risk events. So were patients acquired HIV homosexually (AOR = 0.572; 95% CI: 0.335, 0.978). However, patients who had ART modification were 1.728 times (95% CI: 1.093, 2.732) more likely to have VL high-risk events, and patients who used cotrimoxazole during ART were 1.843 times (95% CI: 1.271, 2.672) more likely to have VL high-risk events. A VL greater than 200 copies/ml is a VL high-risk event for VF. Intervention measurements should be adopted to optimize the surveillance of ART in patients who are single or widowed, who have ART modification, and who use cotrimoxazole during ART.
登录
查看更多内容
影响因子：
15.8
作者：
Keiser O;Orrell C;Egger M;Wood R;Brinkhof MW;Furrer H;van Cutsem G;Ledergerber B;Boulle A;Swiss HIV Cohort Study (SHCS) and the International Epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA)
通讯作者：
Swiss HIV Cohort Study (SHCS) and the International Epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA)
影响因子：
3.8
作者：
Lodwick, Rebecca K.;Smith, Colette J.;Phillips, Andrew N.
通讯作者：
Phillips, Andrew N.
DOI：
10.4269/ajtmh.2009.80.583
发表时间：
2009-04-01
影响因子：
3.3
作者：
Beraud, Guillaume;Pierre-Francois, Sandrine;Cabie, Andre
通讯作者：
Cabie, Andre
影响因子：
11.1
作者：
Cheng W;Wu Y;Wen Y;Ma Y;Zhao D;Dou Z;Zhang W;Bulterys M;Zhang F
通讯作者：
Zhang F
影响因子：
5.6
作者：
Iacob SA;Iacob DG;Jugulete G
通讯作者：
Jugulete G