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获得的人类免疫缺陷病毒1型耐药性在美国罗德岛,2004-2021年

Su Aung¹, Vlad Novitsky², Jon Steingrimsson³

¹Department of Medicine, University of California, San Francisco.

The Journal of infectious diseases

|July 23, 2024

概括

人类免疫缺陷病毒1型 (HIV-1) 获得的耐药性 (ADR) 从2004年至2021年显著下降. 监测ADR对于维持有效的抗逆转录病毒疗法 (ART) 成功至关重要.

科学领域:

传染性疾病传染性疾病
病毒学病毒学
药理学药理学是指药理学的学科.

背景情况:

人类免疫缺陷病毒1型 (HIV-1) 获得的耐药性 (ADR) 对抗逆转录病毒治疗 (ART) 的有效性构成重大挑战.
了解ADR的趋势和预测因素对于优化HIV治疗策略至关重要.

研究的目的:

在18年期间 (2004-2021) 评估HIV-1ADR的程度,趋势和影响.
确定与多药性耐药性发展相关的因素,并评估有效治疗选择的可用性.

主要方法:

来自罗德岛的一个大型艾滋病毒中心的聚合HIV-1蛋白酶-逆转录酶-整合酶序列.
利用斯坦福数据库工具来评估ADR的程度和趋势,使用曼-肯达尔统计数据进行趋势分析.
应用多变量回归来识别耐药性的预测因素并评估治疗选择.

主要成果:

在2004年至2021年期间,ADR总体从77%降至49%,主要药物类别的显著下降.
多类抗性也显著下降,从44%降至12%的2类抗性,从12%降至6%的3类抗性.
在2021年,94%的个人可以获得有效的每日一次药片 (OPOD) 治疗方案;然而,男性性别和更高的ART治疗方案暴露与抗药性增加和较少的OPOD选择有关.

结论:

综合分析显示,18年来HIV-1ADR显著下降,表明ART有效性得到改善.
对ADR的持续监测至关重要,特别是随着整合酶链转移抑制剂 (INSTIs) 和新型双和长效ART配方的日益使用.
这些发现强调了监测抗药性模式的重要性,以确保在不断变化的艾滋病毒治疗环境中持续的ART成功.

关键词:

艾滋病毒-1 耐药性抗药性获得的耐药性获得的耐药性多类电阻的多类电阻.一个药丸-每天服用一次的治疗选择.治疗历史记录治疗历史记录

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