间歇性病毒性病的流行率和预测值与组合HIV治疗
D V Havlir1, R Bassett, D Levitan
1University of California, San Diego, 150 W Washington, Suite 100, San Diego, CA 92103, USA. dhavlir@ucsd.edu
JAMA
|July 13, 2001
概括
在接受抗逆转录病毒治疗的患者中,间歇性病毒性病,或短暂可检测的HIVRNA水平是常见的. 这项研究发现,它不会增加病毒学失败的风险,这表明可能不需要改变治疗方法.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 抗逆转录病毒疗法 (ART) 旨在在艾滋病毒患者中抑制病毒性疾病.
- 间歇性低水平病毒病 (HIV RNA>50拷贝/毫升) 已观察到,但其临床影响尚不清楚.
研究的目的:
- 调查间歇性病毒病是否预测病毒学失败 (HIV RNA>200副本/毫升).
主要方法:
- 对两个队列的回顾性分析:ACTG 343 (n=241) 和默克 035 (n=13).
- 评估了间歇性病毒血症和病毒学失败之间的关联.
- 分析了耐药性和病毒复制水平.
主要成果:
- 在ACTG 343患者中,间歇性病毒病发生在40%的患者中;它没有预测病毒学失败 (RR 0.76,CI 0.29-1.72).
- 在Merck 035中,间歇性病毒性血与更高的病毒复制相关 (P=.03) 但不是病毒学失败.
- 没有发现药物耐药性进化的证据.
结论:
- 间歇性病毒血常见,但与初始组合ART患者的病毒学失败无关.
- 治疗调整可能不需要管理间歇性病毒病症,以保持长期抑制.
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