抗逆转录病毒药物的使用与南非农村年轻女性中的 HIV 耐药性：HPTN 068
Antiretroviral Drug Use and HIV Drug Resistance Among Young Women in Rural South Africa: HPTN 068.
机构信息
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
Statistical Center for HIV/AIDS Research & Prevention (SCHARP), Seattle, WA.
出版信息
J Acquir Immune Defic Syndr. 2018 Nov 1;79(3):315-322. doi: 10.1097/QAI.0000000000001793.
BACKGROUND
Antiretroviral (ARV) drugs are used for HIV treatment and prevention. We analyzed ARV drug use and HIV drug resistance in a cohort of young women in rural South Africa enrolled in the HIV Prevention Trials Network (HPTN) 068 study, which evaluated the use of a cash transfer conditional on school attendance to reduce HIV incidence.
METHODS
ARV drug testing was performed using plasma samples from 2526 young women. This included 2526 enrollment samples (80 HIV-infected and 2446 HIV-uninfected) and 162 seroconversion samples (first HIV-positive study visit). Testing was performed using a qualitative assay that detects 20 ARV drugs from 5 drug classes. HIV drug resistance testing was performed with the ViroSeq HIV-1 Genotyping System for samples that had HIV viral loads ≥400 copies per milliliter.
RESULTS
At enrollment, ARV drugs were detected in 10 (12.5%) of 80 HIV-infected young women. None of 2446 HIV-uninfected young women had ARV drugs detected at enrollment. ARV drugs were also detected in 16 (9.9%) of 162 seroconverters. At enrollment, 9 (13.4%) of 67 young women with genotyping results had HIV drug resistance; resistance was also detected in 9 (6.9%) of 131 seroconverters with genotyping results.
CONCLUSIONS
Most of the HIV-infected young women in this cohort from rural South Africa were not taking ARV drugs, suggesting they were unaware of their HIV status or were not in care. HIV drug resistance was detected in young women with both prevalent and new HIV infection.
背景
抗逆转录病毒 (ARV) 药物用于治疗和预防 HIV。我们分析了在南非农村地区参加 HIV 预防试验网络 (HPTN) 068 研究的年轻女性队列中 ARV 药物的使用情况和 HIV 耐药性，该研究评估了根据上学出勤率发放现金转移的方式以降低 HIV 发病率。
方法
使用来自 2526 名年轻女性的血浆样本进行 ARV 药物检测。这包括 2526 名入组样本（80 名 HIV 感染和 2446 名 HIV 未感染）和 162 名血清转换样本（首次 HIV 阳性研究就诊）。检测使用一种定性检测方法进行，该方法可从 5 种药物类别中检测 20 种 ARV 药物。对于 HIV 病毒载量≥400 拷贝/毫升的样本，使用 ViroSeq HIV-1 基因分型系统进行 HIV 耐药性检测。
结果
在入组时，80 名 HIV 感染的年轻女性中有 10 名（12.5%）检测到 ARV 药物。2446 名 HIV 未感染的年轻女性中没有检测到 ARV 药物。在 16 名（9.9%）血清转换者中也检测到 ARV 药物。在入组时，有基因分型结果的 67 名年轻女性中有 9 名（13.4%）存在 HIV 耐药性；有基因分型结果的 131 名血清转换者中有 9 名（6.9%）也检测到耐药性。
结论
南非农村地区该队列中的大多数 HIV 感染年轻女性未服用 ARV 药物，这表明她们不知道自己的 HIV 状况或未接受治疗。在新感染和现患 HIV 的年轻女性中均检测到 HIV 耐药性。
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