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全球范围内 HIV 和器官移植患者巨细胞病毒感染中表型和基因型更昔洛韦耐药的估计;系统评价和荟萃分析。

Global estimate of phenotypic and genotypic ganciclovir resistance in cytomegalovirus infections among HIV and organ transplant patients; A systematic review and meta-analysis.

机构信息

Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Microb Pathog. 2020 Apr;141:104012. doi: 10.1016/j.micpath.2020.104012. Epub 2020 Jan 29.

Abstract

Human cytomegalovirus (CMV), an opportunistic pathogen belonging to Herpesviridae family, is considered as one of the major causes of morbidity and mortality among wide variety of patients, particularly in transplant recipients and HIV positive patients. As this virus can be resistant to treatment, frequency of CMV in patients who receive organ transplantation and people suffering from AIDS was studied between 1980 and 2019. Medline (via PubMed), Embase, Web of Science, and the Iranian Database were reviewed, and Comprehensive Meta-Analysis (V2.0, Biostat) software analyzed all data. Finally, we used Cochran's Q-statistic to encounter heterogeneity between different studies. Meta-analyses indicated, GCV resistance was 14.1% (95% CI 11.2-17.7); however, in patients suffering from AIDS and organ transplantation were 19.5% (95% CI 14.7-25.4) and 11.4% (95% CI 8.1-15.8), respectively. There were increasing rates in the prevalence of GCV resistance in CMV among transplant recipients, and HIV positive patients. Therefore, evaluation of these refractory infections is beneficial.

摘要

人巨细胞病毒(CMV)是一种属于疱疹病毒科的机会性病原体,被认为是多种患者发病和死亡的主要原因之一,特别是在移植受者和 HIV 阳性患者中。由于这种病毒可能具有抗药性,因此在 1980 年至 2019 年间,对接受器官移植的患者和艾滋病患者中的 CMV 频率进行了研究。通过 Medline(通过 PubMed)、Embase、Web of Science 和伊朗数据库进行了检索,并使用 Comprehensive Meta-Analysis(V2.0,Biostat)软件对所有数据进行了分析。最后,我们使用 Cochran 的 Q 统计量来应对不同研究之间的异质性。Meta 分析表明,GCV 耐药率为 14.1%(95%CI 11.2-17.7);然而,在艾滋病患者和器官移植患者中,耐药率分别为 19.5%(95%CI 14.7-25.4)和 11.4%(95%CI 8.1-15.8)。在移植受者和 HIV 阳性患者中,CMV 中 GCV 耐药的流行率呈上升趋势。因此,评估这些难治性感染是有益的。

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