Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Science Facilitation Department, FHI 360, Durham, North Carolina, USA.
Int J Infect Dis. 2021 Mar;104:465-470. doi: 10.1016/j.ijid.2020.12.085. Epub 2021 Jan 10.
HPTN 075 enrolled men who have sex with men (MSM) and transgender women (TGW) in sub-Saharan Africa. Persons in HIV care or on antiretroviral treatment (ART) were not eligible to enroll. We evaluated antiretroviral (ARV) drug use, viral suppression, and drug resistance in this cohort over a 12-month follow-up period.
Assessments included 64 participants with HIV (39 MSM, 24 TGW, and one gender not specified). ARV drugs were detected using a qualitative assay. Viral load (VL) and drug resistance testing were performed using commercial assays.
Over 12 months, the proportion of participants using ARV drugs increased from 28.1% to 59.4% and the proportion with VLs <400 copies/mL increased from 21.9% to 57.8%. The rate of ART failure (detection of drugs without viral suppression) was similar at screening and 12 months (12.0% and 11.1%, respectively) and was similar among MSM and TGW. Two participants developed HIV drug resistance during follow-up.
Over 12 months, ARV drug use in the cohort more than doubled and viral suppression increased nearly threefold without a significant increase in ART failure or drug resistance. These results suggest that ART can be successfully scaled up for HIV prevention and treatment in this high-risk population.
HPTN 075 招募了撒哈拉以南非洲地区的男男性行为者（MSM）和跨性别女性（TGW）。不符合入组条件的包括正在接受艾滋病毒护理或抗逆转录病毒治疗（ART）的人。我们在 12 个月的随访期间评估了该队列中的抗逆转录病毒（ARV）药物使用、病毒抑制和耐药情况。
评估包括 64 名 HIV 感染者（39 名 MSM、24 名 TGW 和 1 名性别不详）。使用定性检测法检测 ARV 药物。使用商业检测法进行病毒载量（VL）和耐药性检测。
在 12 个月内，使用 ARV 药物的参与者比例从 28.1%增加到 59.4%，VL<400 拷贝/ml 的比例从 21.9%增加到 57.8%。筛查时和 12 个月时的 ART 失败率（无病毒抑制时检测到药物）相似（分别为 12.0%和 11.1%），且 MSM 和 TGW 之间相似。两名参与者在随访期间出现了 HIV 耐药性。
在 12 个月内，队列中 ARV 药物的使用增加了一倍以上，病毒抑制增加了近两倍，而 ART 失败或耐药性没有显著增加。这些结果表明，在这一高危人群中，可以成功扩大 ART 的规模，用于 HIV 的预防和治疗。
