低水平的病毒病与病毒学失败有关,但与临床事件无关
Enrique Bernal1,2,3, Rodrigo Martínez-Rodríguez1,2,3, José Miguel Gómez1,2,3
1Unidad de Enfermedades Infecciosas, Hospital General Universitario Reina Sofía.
AIDS (London, England)
|June 4, 2025
概括
艾滋病毒感染者 (PWH) 的低水平病毒性血清 (LLV) 会增加病毒学失败的风险. 然而,LLV似乎没有增加艾滋病,非艾滋病事件或死亡率的可能性,为抗逆转录病毒疗法 (ART) 上的PWH提供了保证.
科学领域:
- 艾滋病毒/艾滋病研究研究
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 抗逆转录病毒疗法 (ART) 旨在在艾滋病毒感染者 (PWH) 中检测不到的病毒载量.
- 低水平病毒性血清 (LLV),定义为50-200副本/毫升,在ART期间是一个潜在的担忧.
- 了解LLV对治疗结果的影响对于管理艾滋病毒至关重要.
研究的目的:
- 为了评估LLV和PWH在ART上的病毒学失败之间的关联.
- 评估LLV和严重的临床事件,包括艾滋病和非艾滋病事件 (NAE) 之间的关系.
- 确定影响LLV及其结果的社会人口和临床因素.
主要方法:
- 来自西班牙艾滋病毒/艾滋病研究网络 (CoRIS) 的ART-naive成年人的回顾性分析.
- 实现病毒抑制的参与者根据病毒载量测量被分为没有LLV和LLV组.
- 分析的结果包括病毒学失败,艾滋病和严重的NAE,使用竞争性风险分析和后勤回归.
主要成果:
- 在12110名参与者中,LLV在10.3%的参与者中被观察到,并且与更高的中位数年龄和更低的CD4+计数有关.
- 病毒学失败在LLV组 (12.3%) 与没有LLV组 (4.68%) 相比显著更高 (P < 0.001).
- 尽管病毒学失败的危险比率较高 (HR 1.39),但LLV与艾滋病,死亡率或严重的NAE风险增加无关.
结论:
- LLV (50-200副本/毫升) 与ART的PWH病毒学失败风险增加有关.
- 似乎LLV并没有提高艾滋病,NAE或死亡等不良临床结果的风险.
- 对于患有LLV的个体,建议对病毒学失败进行密切监测,但目前的发现表明临床稳定性.
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