牙买加初治慢性感染患者的HIV-1耐药性
HIV-1 drug resistance in treatment-naive chronically infected patients in Jamaica.
作者信息
Barrow Geoffrey J, Hylton-Kong Tina, Rodriguez Nayra, Yamamura Yasuhiro, Figueroa J Peter
出版信息
Antivir Ther. 2013;18(7):941-4. doi: 10.3851/IMP2648.
BACKGROUND
HIV-1 drug resistance in treatment-naive patients has a significant impact on the individual patient as well as implications for the wider population. These effects are amplified in the context of resource-limited settings, which are rapidly expanding access to antiretroviral therapy.
METHODS
This cross-sectional survey at a single treatment site in Kingston, Jamaica was designed to identify the prevalence of HIV-1 drug-resistant mutations in chronically infected, treatment-naive patients. Mutations were identified using the Stanford HIV database algorithm and the World Health Organization (WHO) HIV Drug Resistance (HIVDR) surveillance mutations.
RESULTS
The inclusion of 103 cases in the study resulted in 79 (76.6%) amplifiable samples. Genotype analysis revealed that 12.6% (95% CI 5.3, 19.9) were identified as having clinically significant mutations, while 10.1% (95% CI 3.5, 16.7) had WHO HIVDR surveillance mutations.
CONCLUSIONS
According to the WHO standard, this study population has a moderate level of HIVDR in treatment-naive patients and strongly implies the need to introduce HIVDR surveillance in Jamaica.
背景
初治患者的HIV-1耐药性对个体患者有重大影响，也对更广泛的人群有影响。在资源有限的环境中，这些影响会被放大，因为这些环境正在迅速扩大抗逆转录病毒疗法的可及性。
方法
在牙买加金斯敦的一个单一治疗地点进行的这项横断面调查旨在确定慢性感染的初治患者中HIV-1耐药突变的流行情况。使用斯坦福HIV数据库算法和世界卫生组织（WHO）的HIV耐药性（HIVDR）监测突变来识别突变。
结果
该研究纳入103例病例，其中79例（76.6%）样本可扩增。基因型分析显示，12.6%（95%可信区间5.3，19.9）被确定有临床显著突变，而10.1%（95%可信区间3.5，16.7）有WHO HIVDR监测突变。
结论
根据WHO标准，该研究人群中初治患者的HIVDR处于中等水平，强烈表明牙买加需要引入HIVDR监测。
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