J Acquir Immune Defic Syndr. 2012 Mar 1;59(3):294-9. doi: 10.1097/QAI.0b013e31823fe66b.
Despite the increasing success of antiretroviral therapy (ART), virologic failure of the 3 original classes [triple-class virologic failure, (TCVF)] still develops in a small minority of patients who started therapy in the triple combination ART era. Trends in the incidence and prevalence of TCVF over calendar time have not been fully characterised in recent years.
Calendar time trends in the incidence and prevalence of TCVF from 2000 to 2009 were assessed in patients who started ART from January 1, 1998, and were followed within the Collaboration of Observational HIV Epidemiological Research Europe (COHERE).
Of 91,764 patients followed for a median (interquartile range) of 4.1 (2.0-7.1) years, 2722 (3.0%) developed TCVF. The incidence of TCVF increased from 3.9 per 1000 person-years of follow-up [95% confidence interval (CI): 3.7 to 4.1] in 2000 to 8.8 per 1000 person-years of follow-up (95% CI: 8.5 to 9.0) in 2005, but then declined to 5.8 per 1000 person-years of follow-up (95% CI: 5.6 to 6.1) by 2009. The prevalence of TCVF was 0.3% (95% CI: 0.27% to 0.42%) at December 31, 2000, and then increased to 2.4% (95% CI: 2.24% to 2.50%) by the end of 2005. However, since 2005, TCVF prevalence seems to have stabilized and has remained below 3%.
The prevalence of TCVF in people who started ART after 1998 has stabilized since around 2005, which most likely results from the decline in incidence of TCVF from this date. The introduction of improved regimens and better overall HIV care is likely to have contributed to these trends. Despite this progress, calendar trends should continue to be monitored in the long term.
尽管抗逆转录病毒疗法（ART）取得了越来越大的成功，但在开始三联疗法时代接受治疗的少数患者中，仍会出现三种原药类别的病毒学失败（TCVF）。近年来，TCVF 的发病率和患病率随时间的变化趋势尚未得到充分描述。
在 1998 年 1 月 1 日开始接受抗逆转录病毒治疗并在合作观察艾滋病毒流行病学研究欧洲（COHERE）中进行随访的患者中，评估了 2000 年至 2009 年 TCVF 的发病率和患病率随日历时间的变化趋势。
在中位（四分位间距）随访 4.1 年（2.0-7.1 年）的 91764 例患者中，有 2722 例（3.0%）发生了 TCVF。TCVF 的发病率从 2000 年的每 1000 人年随访 3.9 例（95%可信区间：3.7-4.1）增加到 2005 年的每 1000 人年随访 8.8 例（95%可信区间：8.5-9.0），但随后在 2009 年下降至每 1000 人年随访 5.8 例（95%可信区间：5.6-6.1）。TCVF 的患病率在 2000 年 12 月 31 日为 0.3%（95%可信区间：0.27%-0.42%），然后在 2005 年底增加至 2.4%（95%可信区间：2.24%-2.50%）。然而，自 2005 年以来，TCVF 的患病率似乎已经稳定，并且一直保持在 3%以下。
自 1998 年以来开始接受抗逆转录病毒治疗的患者中 TCVF 的患病率自 2005 年以来已经稳定，这很可能是由于自该日期以来 TCVF 的发病率下降所致。引入改良方案和更好的整体 HIV 护理可能促成了这些趋势。尽管取得了这些进展，但仍需在长期内继续监测日历趋势。
