在杜洛特格拉维尔过渡期间的HIV-1病毒载量抑制和耐药性的模式:基于人口的纵向研究
Michael A Martin1, Alexandra Blenkinsop2,3, Michelle Moffa4
1Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
medRxiv : the preprint server for health sciences
|September 15, 2025
概括
基于多卢特格拉维尔 (DTG) 的艾滋病毒治疗方案在乌干达超过10年的时间里显著改善了病毒抑制. 虽然整体抗逆转录病毒 (ART) 耐药性下降,但低水平的INSTI耐药性需要继续进行基因组监测.
科学领域:
- 艾滋病毒/艾滋病研究研究
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 在撒哈拉以南非洲,基于多卢特格拉维尔 (DTG) 的艾滋病毒治疗方案对人口水平的影响的数据有限.
- 这项研究评估了乌干达南部的病毒抑制和抗逆转录病毒 (ART) 耐药性,长达十年的DTG扩展.
研究的目的:
- 评估基于DTG的HIV治疗方案的有效性.
- 在乌干达的一大队伍中评估病毒抑制和ART耐药性的趋势.
- 了解DTG扩大规模对艾滋病毒治疗结果的影响.
主要方法:
- 利用了来自Rakai社区队列研究 (2011-2023) 的数据,其中包括20383名艾滋病毒感染者 (PLHIV).
- 收集了关于问卷,艾滋病毒检测,病毒载量和病毒深度测序的数据.
- 估计HIV抑制 (<1,000副本/毫升) 和ART耐药性使用强大的Poisson和贝叶斯逻辑回归.
主要成果:
- 在2014年至2022年期间,病毒抑制率从57.1%增加到90.3%.
- 到2020年,84.4%的男性和64.6%的女性使用了DTG疗法.
- 在经过治疗的病毒性PLHIV中,整体ART耐药性从51.1%降至27.9%.
- 观察到最小的中级/高水平DTG耐药性;在7.5%的病毒性个体中检测到低水平的INSTI耐药性 (inS153Y).
结论:
- 基于DTG的治疗方案与乌干达的病毒抑制增加和ART耐药性降低有关.
- 对ART的坚持在降低病毒血量方面起着至关重要的作用.
- 持续对ART耐药性的基因组监测,特别是对于像insti153Y这样的INSTI耐药性突变,至关重要.
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