UCL Medical School, Royal Free Campus, London, UK.
HIV Med. 2010 Aug;11(7):432-8. doi: 10.1111/j.1468-1293.2009.00809.x. Epub 2010 Feb 8.
Effective antiretroviral therapy (ART) has transformed the care of people with HIV, but it is important to monitor time trends in indicators of treatment success and antic future changes.
We assessed time trends from 2000 to 2007 in several indicators of treatment success in the UK Collaborative HIV Cohort (CHIC) Study, and using national HIV data from the Health Protection Agency (HPA) we developed a model to project future trends.
The proportion of patients on ART with a viral load <50 HIV-1 RNA copies/mL increased from 62% in 2000 to 84% in 2007, and the proportion of all patients with a CD4 count <200 cells/microL decreased from 21% to 10%. During this period, the number of patients who experienced extensive triple class failure (ETCF) rose from 147 (0.9%) to 1771 (3.9%). The number who experienced such ETCF and had a current viral load >50 copies/mL rose fromz 118 (0.7%) to 857 (1.9%). Projections to 2012 suggest sustained high levels of success, with a continued increase in the number of patients who have failed multiple drugs but a relatively stable number of such patients experiencing viral loads >50 copies/mL. Numbers of deaths are projected to remain low.
There have been continued improvements in key indicators of success in patients with HIV from 2000 to 2007. Although the number of patients who have ETCF is projected to rise in the future, the number of such patients with viral loads >50 copies/mL is not projected to increase up to 2012. New drugs may be needed in future to sustain these positive trends.
有效的抗逆转录病毒疗法（ART）改变了艾滋病毒感染者的治疗模式，但监测治疗成功指标的时间趋势以及预测未来变化非常重要。
我们评估了英国协作艾滋病毒队列（CHIC）研究中 2000 至 2007 年几种治疗成功指标的时间趋势，并利用英国健康保护署（HPA）的国家艾滋病毒数据建立了一个模型，预测未来的趋势。
接受病毒载量<50 HIV-1 RNA 拷贝/ml 的 ART 患者比例从 2000 年的 62%增加到 2007 年的 84%，所有 CD4 计数<200 个细胞/μl 的患者比例从 21%降至 10%。在此期间，广泛三重耐药（ETCF）患者的数量从 147 例（0.9%）增加到 1771 例（3.9%）。经历此类 ETCF 且目前病毒载量>50 拷贝/ml 的患者数量从 118 例（0.7%）增加到 857 例（1.9%）。到 2012 年的预测显示，成功水平持续较高，尽管经历多种药物耐药的患者数量预计会增加，但此类患者中病毒载量>50 拷贝/ml 的比例预计不会增加到 2012 年。预计死亡人数将保持较低水平。
从 2000 年到 2007 年，艾滋病毒感染者的关键成功指标持续得到改善。尽管未来预计 ETCF 患者数量会增加，但到 2012 年，此类患者中病毒载量>50 拷贝/ml 的患者数量预计不会增加。未来可能需要新的药物来维持这些积极趋势。
