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赞比亚卢萨卡大学教学医院成人传染病中心采用基于 NNRTI 的一线抗逆转录病毒疗法治疗 HIV-2 与 HIV-1 患者的结局和特征比较。

Treatment outcomes and characteristics of HIV-2 patients compared to HIV-1 patients on an NNRTI-based first line art at the adult infectious diseases centre of the University Teaching Hospital (UTH) in Lusaka.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.

Tropical Diseases Research Centre, Ndola, Zambia.

出版信息

Pan Afr Med J. 2021 Dec 16;40:231. doi: 10.11604/pamj.2021.40.231.25149. eCollection 2021.

Abstract

INTRODUCTION

the focus of antiretroviral therapy (ART) in Zambia has been on HIV-1. However, some patients are infected with HIV-2 or both. HIV-2 is resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs), drugs used for HIV-1. Therefore, this study sought to determine the seroprevalence of HIV-2 or dual infection in HIV infected individuals and compare the treatment outcomes associated with HIV subtype in patients taking NNRTI-based first line cART at the University Teaching Hospitals (UTH).

METHODS

this was a cross- sectional study, we collected data from the Virological Impact of Switching from Efavirenz and Nevirapine based first-line cART regimens to Dolutegravir (VISEND) study being conducted at UTH. Ninety six individuals were included in the study. Descriptive and inferential statistics were performed. Logistic regression was used to assess the relationship between treatment outcomes and HIV type.

RESULTS

the proportion of HIV 1 and 2 co-infected patients was 5.2% (95% CI 2%-12%). The mean age was 46 years ± 2 years with 60 (62.5%) being females. The median viral load was 1.3 log 10 copies/ml, IQR 0-1.7 log 10 copies/ml and the median absolute CD4+ T cell count increased from 231 to 463 cells/mm (p < 0.001) after being on cART for one year or more. The study did not report any associations between treatment outcomes and HIV type (p > 0.05).

CONCLUSION

there is a small proportion of patients that are HIV 1 and 2 co-infected but are on an NNRTI-based cART regimen, drugs that are not active against HIV-2. This, however, does not seem to significantly affect the patient´s virological or immunological treatment outcome.

摘要

引言

赞比亚抗逆转录病毒疗法(ART)的重点一直是 HIV-1。然而,一些患者感染了 HIV-2 或两者都有。HIV-2 对非核苷类逆转录酶抑制剂(NNRTIs)耐药,而 NNRTIs 是用于治疗 HIV-1 的药物。因此,本研究旨在确定感染 HIV 的个体中 HIV-2 或双重感染的血清流行率,并比较在大学教学医院(UTH)接受基于 NNRTI 的一线 cART 的患者中与 HIV 亚型相关的治疗结果。

方法

这是一项横断面研究,我们从正在 UTH 进行的从依非韦伦和奈韦拉平为基础的一线 cART 方案转换为多替拉韦的病毒学影响(VISEND)研究中收集数据。研究纳入了 96 名患者。进行了描述性和推断性统计分析。使用逻辑回归评估治疗结果与 HIV 类型之间的关系。

结果

HIV 1 和 2 合并感染患者的比例为 5.2%(95%CI 2%-12%)。平均年龄为 46 岁±2 岁,其中 60 名(62.5%)为女性。中位病毒载量为 1.3 log 10 拷贝/ml,IQR 0-1.7 log 10 拷贝/ml,且在接受 cART 治疗一年或更长时间后,中位绝对 CD4+T 细胞计数从 231 增加到 463 个细胞/mm(p<0.001)。研究未报告治疗结果与 HIV 类型之间存在任何关联(p>0.05)。

结论

有一小部分患者同时感染了 HIV 1 和 2,但正在接受基于 NNRTI 的 cART 方案治疗,而 NNRTI 对 HIV-2 无效。然而,这似乎并没有显著影响患者的病毒学或免疫学治疗结果。

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