Wolf T, Fuß B, Khaykin P, Berger A, Knecht G, Gute P, Brodt H R, Goepel S, Bickel M, Stuermer M, Stephan C
Infectious Diseases Unit at Medical Department No. 2, HIVCENTER, Hospital of the Johann Wolfgang Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt, Germany.
Med Microbiol Immunol. 2014 Dec;203(6):409-14. doi: 10.1007/s00430-014-0350-5. Epub 2014 Aug 23.
To evaluate the treatment outcome of antiretroviral therapy, depending on the use and utility of a concept of resistance-guided switch, patients from the Frankfurt HIV cohort have been followed for 24 weeks. If available, prior resistance data have been evaluated and patients were grouped into their expected viral response. The data of 354 patients were thus analysed, taking into account the genotypic sensitivity score of the administered medication (> or ≤2). When looking at the proportion of patients who achieved a viral load of <50/ml, the response rates differed significantly better for patients with a favourable resistance scoring as compared to an unfavourable one (71.9 % as compared to 56.0 %, p = 0.008). Interestingly, patients with a favourable resistance score also showed a better immunological response, as measured by median CD4 cell count of 391/µl [interquartal range (IQR) 250-530/µl] against 287/µl (IQR 174-449/µl) and a larger total increase of 141/µl against 38/µl. A significant virological and immunological benefit could be demonstrated for patients of a cohort with resistance-guided antiretroviral therapy adjustments.
为了评估抗逆转录病毒疗法的治疗效果，根据耐药性引导换药概念的应用和效用，对法兰克福HIV队列中的患者进行了24周的随访。如果有可用的既往耐药数据，则对其进行评估，并将患者按照预期的病毒反应进行分组。因此，分析了354例患者的数据，同时考虑了所使用药物的基因型敏感性评分（>或≤2）。在观察病毒载量<50/ml的患者比例时，耐药评分良好的患者的反应率明显优于评分不佳的患者（分别为71.9%和56.0%，p = 0.008）。有趣的是，耐药评分良好的患者也表现出更好的免疫反应，以CD4细胞计数中位数衡量，分别为391/µl[四分位间距（IQR）250 - 530/µl]和287/µl（IQR 174 - 449/µl），总增加量分别为141/µl和38/µl。对于进行耐药性引导的抗逆转录病毒疗法调整的队列患者，可证明有显著的病毒学和免疫学益处。
