Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
AIDS. 2018 Jun 19;32(10):1301-1306. doi: 10.1097/QAD.0000000000001839.
To analyze antiretroviral drug use and HIV drug resistance among HIV-infected MSM and transgender women who were screened for participation in the HIV Prevention Trials Network 075 study.
A qualitative assay was used to detect 20 antiretroviral drugs in five drug classes; this assay is based on liquid chromatography coupled with high-resolution accurate-mass mass spectrometry. HIV viral load testing was performed using the RealTime HIV-1 Viral Load Assay. HIV drug resistance testing was performed using the ViroSeq HIV-1 Genotyping System. Logistic regression was used to evaluate factors associated with study outcomes.
Antiretroviral drugs were detected in 63 (34.4%) of 183 participants who had confirmed HIV infection at screening; 11 (17.5%) of the 63 participants were not virally suppressed. Six (54.5%) of the 11 participants had drug-resistant HIV, including four who had multiclass resistance. Seven (63.6%) of the 11 were at risk of acquiring resistance to additional antiretroviral drugs. In multivariate model, antiretroviral drugs were more frequently detected in older participants, those recruited from Kisumu, Kenya, and those who reported ever having been in HIV care or on antiretroviral therapy (ART).
Most of HIV-infected persons screened for participation in HIV Prevention Trials Network 075 were not on ART, and many of those who were on ART were not virally suppressed. Many of those participants had drug-resistant HIV. These findings highlight the need for improved HIV care for African MSM and transgender women.
分析参加 HIV 预防试验网络 075 研究的 HIV 感染男男性行为者和跨性别女性中抗逆转录病毒药物的使用情况和 HIV 耐药情况。
采用基于液相色谱-高分辨精确质量质谱联用的定性检测方法，检测五类 20 种抗逆转录病毒药物。采用 RealTime HIV-1 病毒载量测定法进行 HIV 病毒载量检测，采用 ViroSeq HIV-1 基因分型系统进行 HIV 耐药性检测。采用逻辑回归分析评估与研究结果相关的因素。
在筛查时已确认 HIV 感染的 183 名参与者中，有 63 名（34.4%）检测到了抗逆转录病毒药物；其中 11 名（17.5%）未被病毒抑制。在这 11 名参与者中，有 6 名（54.5%）携带耐药性 HIV，其中 4 名有多种药物耐药。在这 11 名参与者中，有 7 名（63.6%）有感染其他抗逆转录病毒药物耐药的风险。在多变量模型中，年龄较大、来自肯尼亚基苏木的参与者、曾接受过 HIV 护理或抗逆转录病毒治疗（ART）的参与者，更频繁地检测到抗逆转录病毒药物。
参加 HIV 预防试验网络 075 研究筛查的大多数 HIV 感染者未接受 ART 治疗，而接受 ART 治疗的感染者中，许多人的病毒并未得到抑制。许多参与者携带耐药性 HIV。这些发现突出了需要改善非洲男男性行为者和跨性别女性的 HIV 护理。
