HIV基因耐药性检测对HIV感染儿童及青少年治疗管理和临床病程的影响。
Effect of HIV genotypic drug resistance testing on the management and clinical course of HIV-infected children and adolescents.
作者信息
Dehority W, Deville J G, Lujan-Zilbermann J, Spector S A, Viani R M
机构信息
Department of Pediatrics, The University of New Mexico Health Sciences Center, MSC10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
出版信息
Int J STD AIDS. 2013 Jul;24(7):549-53. doi: 10.1177/0956462412473958. Epub 2013 Jul 4.
The clinical utility of genotypic drug resistance testing (DRT) in HIV-infected children on antiretroviral therapy (ART) is not well understood. HIV-infected patients aged <19 years undergoing DRT for virological failure were retrospectively enrolled. Indications for DRT and changes in HIV RNA load were recorded. Between January 2000 and December 2006, 57 patients had DRT. The most common indication for DRT was poor ART adherence (57.7% of patients). ART was changed in 50.9% of patients after DRT. Poor adherence was cited by clinicians for not changing ART significantly more often than any other reason (47.3%, P < 0.001). After DRT, significant improvement in HIV RNA load occurred independent of ART changes, though patients whose ART was modified were more likely to become undetectable (31.5% versus 7.0%, P < 0.001). Poor adherence was a significant factor for ordering DRT and for not changing ART in HIV-infected children.
对于接受抗逆转录病毒治疗（ART）的HIV感染儿童，基因型耐药性检测（DRT）的临床效用尚未得到充分了解。对年龄小于19岁、因病毒学失败而接受DRT的HIV感染患者进行回顾性纳入研究。记录DRT的指征以及HIV RNA载量的变化。在2000年1月至2006年12月期间，有57例患者接受了DRT。DRT最常见的指征是ART依从性差（占患者的57.7%）。50.9%的患者在DRT后更改了ART。临床医生指出，依从性差是未更频繁更改ART的原因，其比例显著高于任何其他原因（47.3%，P<0.001）。DRT后，无论ART是否更改，HIV RNA载量均有显著改善，不过接受ART调整的患者更有可能实现病毒载量不可检测（31.5%对7.0%，P<0.001）。依从性差是HIV感染儿童进行DRT以及不更改ART的一个重要因素。
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