中国国家艾滋病治疗规划中接受一线抗逆转录病毒治疗至少 9 个月的患者中的 HIV 耐药性。
HIV drug resistance in patients in China's national HIV treatment programme who have been on first-line ART for at least 9 months.
机构信息
Weifang Medical University, Weifang, 261053, Shandong, China.
State Key Laboratory for Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
出版信息
AIDS Res Ther. 2020 Mar 5;17(1):9. doi: 10.1186/s12981-020-00264-5.
BACKGROUND
The aim of this study was to assess trends in drug resistance and associated clinical and programmatic factors at a national level during the rapid scale up of ART.
METHODS
Logistic regression was used to identify the factors associated with HIVDR. Variables associated with drug resistance in multivariable logistic regression were included in the Cochran-Armitage test for trend.
RESULTS
A total of 11,976 patients were enrolled in the study. The prevalence of HIVDR among patients who received ART for 9-24 months during 2003-2008, 2009-2012, and 2013-2015 significantly decreased (15.5%, 6.3%, and 2.3%, respectively, P < 0.01). With respect to the class of antiretroviral, there were substantial increases in resistance to both non-nucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) (2003-2008, 2009-2012, and 2013-2015: 49.7%, 58.9%, and 73.0%, respectively, P < 0.01). The prevalence of DR to protease inhibitors (PIs) was low, which supported their continued use as second-line therapy in China.
CONCLUSIONS
Our results provide evidence for the effectiveness of China's "Treat All" approach to guide policy makers to improve training for healthcare providers and education on ART adherence among patients.
背景
本研究旨在评估在快速扩大抗逆转录病毒治疗（ART）规模期间，全国范围内耐药趋势以及相关临床和规划因素。
方法
采用逻辑回归分析方法，确定与 HIV 耐药相关的因素。多变量逻辑回归中与耐药相关的变量被纳入 Cochran-Armitage 趋势检验。
结果
共纳入 11976 名患者。2003-2008 年、2009-2012 年和 2013-2015 年，接受 ART 治疗 9-24 个月的患者中 HIV 耐药的发生率分别显著降低（15.5%、6.3%和 2.3%，P<0.01）。在抗逆转录病毒药物种类方面，非核苷类逆转录酶抑制剂（NNRTIs）和核苷类逆转录酶抑制剂（NRTIs）的耐药率均显著增加（2003-2008 年、2009-2012 年和 2013-2015 年：49.7%、58.9%和 73.0%，P<0.01）。蛋白酶抑制剂（PIs）的耐药率较低，支持其在中国继续作为二线治疗药物使用。
结论
本研究结果为中国“全面治疗”方法的有效性提供了证据，有助于指导决策者加强对医护人员的培训，并加强患者对 ART 依从性的教育。
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