• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

开始使用含非核苷类逆转录酶抑制剂的抗逆转录病毒治疗的患者的预处理人类免疫缺陷病毒耐药性的临床影响：系统评价和荟萃分析。

Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor-Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis.

机构信息

Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.

Virology, Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

J Infect Dis. 2021 Aug 2;224(3):377-388. doi: 10.1093/infdis/jiaa683.

DOI:10.1093/infdis/jiaa683
PMID:33202025
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8328216/
Abstract

BACKGROUND

Increased access to antiretroviral therapy (ART) has resulted in rising levels of pretreatment human immunodeficiency virus drug resistance (PDR). This is the first systematic review and meta-analysis to assess the impact of PDR on treatment outcomes among people initiating nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART, including the combination of efavirenz (EFV), tenofovir (TDF), and lamivudine or emtricitabine (XTC).

METHODS

We systematically reviewed studies and conference proceedings comparing treatment outcomes in populations initiating NNRTI-based ART with and without PDR. We conducted subgroup analyses by regimen: (1) NNRTIs + 2 nucleoside reverse transcriptase inhibitors (NRTIs), (2) EFV + 2 NRTIs, or (3) EFV/TDF/XTC; by population (children vs adults); and by definition of resistance (PDR vs NNRTI PDR).

RESULTS

Among 6197 studies screened, 32 were analyzed (31 441 patients). We found that individuals with PDR initiating NNRTIs across all the subgroups had increased risk of virological failure compared to those without PDR. Risk of acquisition of new resistance mutations and ART switch was also higher in people with PDR.

CONCLUSIONS

This review shows poorer treatment outcomes in the presence of PDR, supporting the World Health Organization's recommendation to avoid using NNRTIs in countries where levels of PDR are high.

摘要

背景

抗逆转录病毒疗法（ART）的可及性增加导致了预处理人类免疫缺陷病毒耐药性（PDR）水平的上升。这是第一项评估 PDR 对开始使用非核苷类逆转录酶抑制剂（NNRTI）为基础的 ART 人群治疗结果影响的系统评价和荟萃分析，包括使用依非韦伦（EFV）、替诺福韦（TDF）和拉米夫定或恩曲他滨（XTC）的组合。

方法

我们系统地回顾了比较开始 NNRTI 为基础的 ART 时有无 PDR 的人群治疗结果的研究和会议论文。我们按方案进行了亚组分析：（1）NNRTIs + 2 种核苷逆转录酶抑制剂（NRTIs），（2）EFV + 2 NRTIs，或（3）EFV/TDF/XTC；按人群（儿童与成人）；以及按耐药性定义（PDR 与 NNRTI PDR）。

结果

在筛选的 6197 项研究中，有 32 项进行了分析（31441 名患者）。我们发现，与无 PDR 者相比，所有亚组中开始使用 NNRTIs 的 PDR 个体发生病毒学失败的风险增加。PDR 患者发生新耐药突变和 ART 转换的风险也更高。

结论

本综述表明 PDR 存在时治疗结果较差，支持世界卫生组织建议在 PDR 水平较高的国家避免使用 NNRTI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/65f8a7fae036/jiaa683f0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/84cdc6a2c1c2/jiaa683f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/7a6bfc824092/jiaa683f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/03bbc7283795/jiaa683f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/69386ef1c966/jiaa683f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/2feb44725f88/jiaa683f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/65f8a7fae036/jiaa683f0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/84cdc6a2c1c2/jiaa683f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/7a6bfc824092/jiaa683f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/03bbc7283795/jiaa683f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/69386ef1c966/jiaa683f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/2feb44725f88/jiaa683f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff7/8328216/65f8a7fae036/jiaa683f0006.jpg

相似文献

1
Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor-Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis.开始使用含非核苷类逆转录酶抑制剂的抗逆转录病毒治疗的患者的预处理人类免疫缺陷病毒耐药性的临床影响：系统评价和荟萃分析。
J Infect Dis. 2021 Aug 2;224(3):377-388. doi: 10.1093/infdis/jiaa683.
2
Stavudine, lamivudine and nevirapine combination therapy for treatment of HIV infection and AIDS in adults.司他夫定、拉米夫定与奈韦拉平联合疗法治疗成人HIV感染和艾滋病
Cochrane Database Syst Rev. 2006 Apr 19;2006(2):CD004535. doi: 10.1002/14651858.CD004535.pub2.
3
Brief communication: characteristics of primary drug resistance in newly diagnosed HIV-infected individuals in Ganzhou, China.简短通讯：中国赣州新诊断HIV感染者的原发性耐药特征
AIDS Res Ther. 2025 Jun 16;22(1):63. doi: 10.1186/s12981-025-00758-0.
4
Structured treatment interruptions (STI) in chronic unsuppressed HIV infection in adults.成人慢性未抑制的HIV感染中的结构化治疗中断（STI）
Cochrane Database Syst Rev. 2006 Jul 19;2006(3):CD006148. doi: 10.1002/14651858.CD006148.
5
Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.用于降低人类免疫缺陷病毒感染母婴传播风险的抗逆转录病毒药物。
Cochrane Database Syst Rev. 2007 Jan 24(1):CD003510. doi: 10.1002/14651858.CD003510.pub2.
6
Acquired HIV drug resistance mutations on first-line antiretroviral therapy in Southern Africa: Systematic review and Bayesian evidence synthesis.南非一线抗逆转录病毒治疗中获得性 HIV 耐药突变：系统评价和贝叶斯证据综合。
J Clin Epidemiol. 2022 Aug;148:135-145. doi: 10.1016/j.jclinepi.2022.02.005. Epub 2022 Feb 19.
7
Clinical Pharmacodynamics, Pharmacokinetics, and Drug Interaction Profile of Doravirine.多伟拉韦的临床药效动力学、药代动力学和药物相互作用特征。
Clin Pharmacokinet. 2019 Dec;58(12):1553-1565. doi: 10.1007/s40262-019-00806-9.
8
Clinical efficacy of antiretroviral combination therapy based on protease inhibitors or non-nucleoside analogue reverse transcriptase inhibitors: indirect comparison of controlled trials.基于蛋白酶抑制剂或非核苷类逆转录酶抑制剂的抗逆转录病毒联合疗法的临床疗效：对照试验的间接比较
BMJ. 2004 Jan 31;328(7434):249. doi: 10.1136/bmj.37995.435787.A6. Epub 2004 Jan 23.
9
Three- or four- versus two-drug antiretroviral maintenance regimens for HIV infection.用于治疗HIV感染的三联或四联与二联抗逆转录病毒维持治疗方案
Cochrane Database Syst Rev. 2003(4):CD002037. doi: 10.1002/14651858.CD002037.
10
Progressive resistive exercise interventions for adults living with HIV/AIDS.针对感染艾滋病毒/艾滋病的成年人的渐进性抗阻运动干预措施。
Cochrane Database Syst Rev. 2004 Oct 18(4):CD004248. doi: 10.1002/14651858.CD004248.pub2.

引用本文的文献

1
Epidemic dynamics and clinical characteristics of HIV-1 CRF07_BC_N and CRF07_BC_O in Shanghai, 2017-2023.2017 - 2023年上海HIV-1 CRF07_BC_N和CRF07_BC_O的流行动态及临床特征
Virulence. 2025 Dec;16(1):2554301. doi: 10.1080/21505594.2025.2554301. Epub 2025 Sep 4.
2
HIV-1 Drug Resistance Trends in the Era of Modern Antiretrovirals: 2018-2024.现代抗逆转录病毒药物时代的HIV-1耐药性趋势：2018 - 2024年
Open Forum Infect Dis. 2025 Aug 4;12(8):ofaf446. doi: 10.1093/ofid/ofaf446. eCollection 2025 Aug.
3
The Hallmarks of Ageing in Human Immunodeficiency Virus Infection and the Impact of Antiretroviral Therapy on Telomeres: A Molecular Perspective.

本文引用的文献

1
Reduced efficacy of HIV-1 integrase inhibitors in patients with drug resistance mutations in reverse transcriptase.逆转录酶耐药突变患者中 HIV-1 整合酶抑制剂疗效降低。
Nat Commun. 2020 Dec 1;11(1):5922. doi: 10.1038/s41467-020-19801-x.
2
Evaluation of the management of pretreatment HIV drug resistance by oligonucleotide ligation assay: a randomised controlled trial.寡核苷酸连接分析评估预处理 HIV 耐药性管理：一项随机对照试验。
Lancet HIV. 2020 Feb;7(2):e104-e112. doi: 10.1016/S2352-3018(19)30337-6. Epub 2019 Dec 7.
3
2019 update of the drug resistance mutations in HIV-1.
人类免疫缺陷病毒感染中的衰老特征及抗逆转录病毒疗法对端粒的影响：分子视角
Curr Issues Mol Biol. 2025 Apr 12;47(4):273. doi: 10.3390/cimb47040273.
4
Spatiotemporal patterns and influencing factors of genotypic resistance testing utilization among people living with HIV: A 10-year retrospective analysis at a tertiary care hospital in Beijing, China (2014-2023).艾滋病毒感染者中基因型耐药检测利用的时空模式及影响因素：中国北京一家三级医院的10年回顾性分析（2014 - 2023年）
Biosaf Health. 2025 May 8;7(3):192-198. doi: 10.1016/j.bsheal.2025.05.001. eCollection 2025 Jun.
5
Distinct region-specific neutralization profiles of contemporary HIV-1 clade C against best-in-class broadly neutralizing antibodies.当代HIV-1 C亚型针对同类最佳广泛中和抗体的独特区域特异性中和谱。
J Virol. 2025 Jun 17;99(6):e0000825. doi: 10.1128/jvi.00008-25. Epub 2025 May 16.
6
Impact of HIV Pretreatment Drug Resistance on Secondary Transmission Through Treatment Dropout: A Prospective Population-Based Study in Southwestern China.HIV治疗前耐药性对因治疗中断导致的二代传播的影响：中国西南部一项基于人群的前瞻性研究
Infect Drug Resist. 2025 May 6;18:2311-2327. doi: 10.2147/IDR.S516513. eCollection 2025.
7
The Prevalence of Pretreatment Drug Resistance and Transmission Networks Among Newly Diagnosed HIV-1-Infected Individuals in Nanning, Guangxi, China.中国广西南宁新诊断的HIV-1感染个体中治疗前耐药性和传播网络的流行情况
Pathogens. 2025 Mar 31;14(4):336. doi: 10.3390/pathogens14040336.
8
Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023.东非接受抗逆转录病毒治疗的艾滋病毒感染者中病毒学失败的患病率及预测因素：来自对2016年至2023年已发表研究的系统评价、荟萃分析和荟萃回归的证据
HIV Res Clin Pract. 2025 Dec;26(1):2490774. doi: 10.1080/25787489.2025.2490774. Epub 2025 Apr 11.
9
Lenacapavir disrupts HIV-1 core integrity while stabilizing the capsid lattice.来那卡帕韦破坏HIV-1核心完整性，同时稳定衣壳晶格。
Proc Natl Acad Sci U S A. 2025 Apr 8;122(14):e2420497122. doi: 10.1073/pnas.2420497122. Epub 2025 Apr 1.
10
Prevalence and transmission of HIV-1 drug resistance mutations among patients with treatment failure and newly diagnosed people in Liangshan Prefecture, China, in 2021-2023.2021 - 2023年中国凉山州治疗失败患者及新诊断人群中HIV-1耐药突变的流行情况与传播情况
Front Public Health. 2025 Mar 12;13:1550121. doi: 10.3389/fpubh.2025.1550121. eCollection 2025.
2019年人类免疫缺陷病毒1型耐药性突变的更新情况。
Top Antivir Med. 2019 Sep;27(3):111-121.
4
Dolutegravir-Based or Low-Dose Efavirenz-Based Regimen for the Treatment of HIV-1.基于多替拉韦的或基于低剂量依非韦伦的方案治疗人类免疫缺陷病毒 1 型。
N Engl J Med. 2019 Aug 29;381(9):816-826. doi: 10.1056/NEJMoa1904340. Epub 2019 Jul 24.
5
Increasing levels of pretreatment HIV drug resistance and safety concerns for dolutegravir use in women of reproductive age.治疗前艾滋病毒耐药水平不断上升，且替诺福韦酯和多替拉韦在生育年龄妇女中的应用存在安全性顾虑。
AIDS. 2019 Sep 1;33(11):1797-1799. doi: 10.1097/QAD.0000000000002277.
6
Prevalence of HIV-1 transmitted drug resistance and viral suppression among recently diagnosed adults in São Paulo, Brazil.巴西圣保罗近期诊断出的成年患者中HIV-1传播耐药性和病毒抑制的流行情况。
Arch Virol. 2019 Mar;164(3):699-706. doi: 10.1007/s00705-018-04122-8. Epub 2018 Dec 20.
7
Does Tenofovir-containing First-line Antiretroviral Therapy Mitigate the Impact of Pretreatment Non-nucleoside Reverse Transcriptase Inhibitor Drug Resistance?含替诺福韦的一线抗逆转录病毒疗法能否减轻治疗前非核苷类逆转录酶抑制剂耐药性的影响？
Clin Infect Dis. 2019 May 30;68(12):2158-2160. doi: 10.1093/cid/ciy1070.
8
Impact of Next-generation Sequencing Defined Human Immunodeficiency Virus Pretreatment Drug Resistance on Virological Outcomes in the ANRS 12249 Treatment-as-Prevention Trial.下一代测序定义的人类免疫缺陷病毒预处理耐药对 ANRS 12249 治疗预防试验病毒学结局的影响。
Clin Infect Dis. 2019 Jul 2;69(2):207-214. doi: 10.1093/cid/ciy881.
9
Increasing Prevalence of HIV Pretreatment Drug Resistance in Women But Not Men in Rural Uganda During 2005-2013.在 2005 年至 2013 年期间，乌干达农村地区女性中 HIV 预处理耐药性的流行率不断上升，但男性中并未出现这种情况。
AIDS Patient Care STDS. 2018 Jul;32(7):257-264. doi: 10.1089/apc.2018.0020.
10
HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052.成人接受早期与延迟抗逆转录病毒治疗的 HIV 耐药性：HPTN 052。
J Acquir Immune Defic Syndr. 2018 Apr 15;77(5):484-491. doi: 10.1097/QAI.0000000000001623.