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[布基纳法索博博迪乌拉索苏罗·萨努教学医院接受二线抗逆转录病毒药物治疗的HIV-1患者低水平持续性病毒血症的特征]

[Characteristics of Low-Level Persistent viraemias in HIV-1 Patients Treated with Second-Line ARVs at the Sourô Sanou Teaching Hospital of Bobo-Dioulasso (Burkina Faso)].

作者信息

Zoungrana J, Kyelem C G, Sondo K A, Naibi K A, Hema A, Kabore N F, Poda A, Bado A, Yaméogo I, Séré H, Ouedraogo A S, Tani S, Tarnagda Z

机构信息

Service des maladies infectieuses du CHU Sanou Sourô Bobo-Dioulasso, Burkina Faso.

Service de médecine interne du CHU Sanou Sourô Bobo-Dioulasso, Burkina Faso.

出版信息

Bull Soc Pathol Exot. 2018;111(3):161-166. doi: 10.3166/bspe-2018-0039.

Abstract

We describe the characteristics of patients infected with HIV-1 as second-line antiretroviral therapy, with persisting low-level viremia. This was a descriptive retrospective study, conducted from January 1, 2010 to December 31, 2016, from the Cohort of the Infectious Diseases Department of Bobo-Dioulasso University Hospital. Patients infected with HIV-1, a second line of stable ARV treatment, with ≥95% compliance for at least 12 months, asymptomatic with CVp between 50 and 1000 copies/ml in two consecutive samplings at least 3 months apart. Out of 244 patients in second-line therapy, 79 met our inclusion criteria. The mean age of the patients was 42±10.2 years. Women (35.8 years) were younger than men (43.8 years) (p=0.001). Most were married (48.1%), 23.5% of whom were polygamous. The majority of patients (38/79) in the study had a CD4 count of <200 cells/ mm. The median duration of ARV therapy since the beginning of the therapeutic history has been 4.8 (2.5-11 years). CVp greater than 10,000 copies/ml at the start of second-line therapy (p=0.003) and TDF+FTC + DRV + RTV combination (p=0.001) were associated with persistent low viremia. A genotypic resistance test is needed for these patients in order to better adapt the ARV treatment.

摘要

我们描述了接受二线抗逆转录病毒疗法但仍存在低水平病毒血症的HIV-1感染患者的特征。这是一项描述性回顾性研究,于2010年1月1日至2016年12月31日在博博迪乌拉索大学医院传染病科队列中进行。HIV-1感染患者,接受二线稳定抗逆转录病毒治疗,至少12个月依从性≥95%,无症状,在至少间隔3个月的两次连续采样中,血浆病毒载量(CVp)在50至1000拷贝/毫升之间。在244例接受二线治疗的患者中,79例符合我们的纳入标准。患者的平均年龄为42±10.2岁。女性(35.8岁)比男性(43.8岁)年轻(p=0.001)。大多数人已婚(48.1%),其中23.5%为一夫多妻制。研究中的大多数患者(38/79)CD4细胞计数<200个/立方毫米。自治疗开始以来抗逆转录病毒治疗的中位持续时间为4.8(2.5 - 11年)。二线治疗开始时血浆病毒载量大于10,000拷贝/毫升(p=0.003)和替诺福韦酯+恩曲他滨+达芦那韦+利托那韦组合(p=0.001)与持续低病毒血症相关。这些患者需要进行基因型耐药检测,以便更好地调整抗逆转录病毒治疗方案。

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