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坦桑尼亚艾滋病毒患者获得的耐药性突变和流通的HIV-1亚型的规模和模式,系统性审查和元分析

Shimba Henerico¹, Christa Kasang^2,3, Benson R Kidenya⁴

¹Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania.

|August 28, 2025

概括

艾滋病毒药物耐药性突变 (DRM) 是一个主要问题. 该审查发现坦桑尼亚DRM的流行率很高,特别是针对NRTI和NNRTIs,但对INSTIs和PI的抵抗力很低.

科学领域:

传染性疾病
病毒学
公共卫生

背景情况:

艾滋病毒药物耐药性突变 (DRM) 威胁到有效的抗逆转录病毒治疗 (ART).
了解DRM模式对于坦桑尼亚的HIV治疗政策至关重要.

研究的目的:

确定在坦桑尼亚接受ART治疗的HIV患者中DRM的患病率和模式.
为优化艾滋病治疗策略和监测提供证据.

主要方法:

在MEDLINE,PubMed,Embase和CINAHL的系统文献搜索到2024年12月.
分析了23项符合条件的研究数据,其中包括9685名艾滋病毒患者.
在不同ART疗法中对病毒学失败和DRM患病率的元分析.

主要成果:

观察到主要DRM的高患病率 (87. 61%).
病毒学失败率为24. 83% (> 1000 个副本/ ml) 和36. 94% (> 400 个副本/ ml).
对核酸逆转录酶抑制剂 (NRTIs) 和非核酸逆转录酶抑制剂 (NNRTIs) 的DRM的患病率很高,而对整合链转移抑制剂 (INSTIs) 和蛋白酶抑制剂 (PI) 的耐药性很低.

结论:

在坦桑尼亚,继续使用基于PI和INSTI的疗法得到了支持.
持续监测DRM对于监测治疗有效性和调整公共卫生策略至关重要.
影响DRM模式的HIV-1亚型C,A1和D是最常见的.

关键词:

艾滋病毒耐药性艾滋病毒-1亚型坦桑尼亚系统审查和元分析

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