在与男性发生性关系的男性中发生性传播的性传播感染,这些男性患有耐福维尔/埃姆特里西塔宾或卡博特格拉维尔抗性艾滋病毒
Tommaso Clemente1,2, Michele Bellomo2, Angelo Roberto Raccagni1,2
1Vita-Salute San Raffaele University, Milan, Italy.
AIDS (London, England)
|May 6, 2025
概括
性传播感染 (STIs) 发生在与艾滋病毒感染者 (MSMWH) 发生性关系的男性中,即使对艾滋病毒暴露前预防 (PrEP) 药物 (如tenofovir/emtricitabine (TXF/FTC) 和cabotegravir (CAB) 药物) 产生抵抗力. 性传播感染的发病率较低,但在具有耐药性HIV菌株的人群中仍然存在.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 公共卫生 公共卫生
背景情况:
- 性传播感染 (STIs) 增加了艾滋病毒传播风险.
- 艾滋病毒的耐药性引起了人们对暴露前预防 (PrEP) 疗效的担忧.
- 与艾滋病毒感染者发生性关系的男性 (MSMWH) 是监测这些风险的关键人口.
研究的目的:
- 为了调查性传播感染的发病率在MSMWH与艾滋病毒耐药的tenofovir/emtricitabine (TXF/FTC) 和/或cabotegravir (CAB).
- 评估艾滋病毒抗药性对该队列中性传播疾病发生的影响.
主要方法:
- 对MSMWH接受抗逆转录病毒治疗 (ART) 的回顾性队列研究.
- 包括针对HIV整合酶的基因型定型耐药性测试 (GRT).
- 分析了Neisseria gonorrhoeae,Chlamydia trachomatis,Mycoplasma/Ureaplasma spp.,梅毒和mopox的发生率.
- 使用Poisson回归模型发生率 (IRs) 和置信区间 (CI).
主要成果:
- 在638个MSMWH中,10.5%具有TXF/FTC耐药性,0.6%具有CAB耐药性,2.0%具有联合耐药性.
- 在5908人年的随访期间,48.1%的人患有744种性传播感染 (IR = 12.6/100 PY).
- 艾滋病毒药物耐药性 (TXF/FTC-或CAB-R) 与显著较低的性病发病率相关 (IRR = 0.6 至 0.2).
结论:
- 在MSMWH中,STI发病率仍然很大,即使HIV对TXF/FTC和/或CAB有抗性.
- 在药物耐药性存在的情况下,观察到STI发病率减少.
- 艾滋病毒耐药性测试结果应该为讨论关于未被PrEP覆盖的性传播风险提供信息.
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