对非核苷类逆转录酶抑制剂的预先存在的耐药性预示着在初治的HIV-1感染受试者中，基于依非韦伦的治疗方案会出现病毒学失败。

Preexisting resistance to nonnucleoside reverse-transcriptase inhibitors predicts virologic failure of an efavirenz-based regimen in treatment-naive HIV-1-infected subjects.

作者信息

Kuritzkes Daniel R, Lalama Christina M, Ribaudo Heather J, Marcial Michelle, Meyer William A, Shikuma Cecilia, Johnson Victoria A, Fiscus Susan A, D'Aquila Richard T, Schackman Bruce R, Acosta Edward P, Gulick Roy M

机构信息

Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA.

出版信息

J Infect Dis. 2008 Mar 15;197(6):867-70. doi: 10.1086/528802.

DOI:10.1086/528802

PMID:18269317

Abstract

A case-cohort study was used to determine the effect of baseline nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance, as assessed by viral genotyping, on the response to efavirenz-containing regimens in AIDS Clinical Trials Group A5095. The sample included a random cohort of efavirenz-treated subjects plus unselected subjects who experienced virologic failure. Of 220 subjects in the random cohort, 57 (26%) had virologic failure. The prevalence of baseline NNRTI resistance was 5%. The risk of virologic failure for subjects with baseline NNRTI resistance was higher than that for subjects without such resistance (hazard ratio 2.27 [95% confidence interval], 1.15-4.49; P = .018). These results support resistance testing before starting antiretroviral therapy.

摘要

在艾滋病临床试验组A5095中，采用病例队列研究来确定通过病毒基因分型评估的基线非核苷类逆转录酶抑制剂（NNRTI）耐药性对含依非韦伦方案疗效的影响。样本包括依非韦伦治疗受试者的随机队列以及经历病毒学失败的未选择受试者。随机队列中的220名受试者中，57名（26%）出现病毒学失败。基线NNRTI耐药的患病率为5%。基线NNRTI耐药受试者的病毒学失败风险高于无此类耐药受试者（风险比2.27 [95%置信区间]，1.15 - 4.49；P = 0.018）。这些结果支持在开始抗逆转录病毒治疗前进行耐药检测。