Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
Department of HIV/STD Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
J Clin Pharm Ther. 2022 Nov;47(11):1729-1737. doi: 10.1111/jcpt.13772. Epub 2022 Sep 18.
Except for the transmitted drug resistance (TDR)'s standard sampling and monitoring protocol, China's HIV-1 pretreatment drug resistance (PDR) and acquired drug resistance (ADR) results vary widely due to the studies' diverse background. This meta-analysis was conducted to comprehensively understand the drug resistance profiles of Chinese HIV/AIDS patients and compare the drug resistance differences among groups to provide a reference for the further improvement of treatment protocols.
Data sources for this study were WANFANG, VIP, CNKI, SinoMed, PubMed and Web of Science databases from January 1, 2010 to January 13, 2022. Data extracted from the literature were analyzed by R and Stata to evaluate the profile and changing trend of drug resistance in Chinese HIV/AIDS patients.
One hundred twenty-one literature were included. The combined PDR and ADR in the Chinese HIV/AIDS patients was 5.56% (95% CI: 4.77%-6.41%) and 51.33% (95% CI: 47.57%-55.38%), respectively. The time trend analysis shows the upward trend of PDR. There were significate differences in ADR among different sample sources, the ADR in the central region were higher than those in all other regions. The PDR in men who have sex with men (MSM) was lower the whole population, while the MSM's ADR was much higher than whole population.
PDR in China showed an upward trend and exceeded the 5% warning line but is still at a low level worldwide. ADR is stable and below the middle level globally; the comprehensively promoted free ART in China still has lasting effects. MSM is the high-risk drug resistance population, targeted treatment strategies should be used.
除了传播耐药性（TDR）的标准采样和监测方案外，由于研究背景的多样性，中国 HIV-1 治疗前耐药性（PDR）和获得性耐药性（ADR）结果差异很大。本荟萃分析旨在全面了解中国 HIV/AIDS 患者的耐药谱，并比较组间耐药差异，为进一步完善治疗方案提供参考。
本研究的数据来源为 2010 年 1 月 1 日至 2022 年 1 月 13 日期间的万方、维普、中国知网、中国生物医学文献服务系统、PubMed 和 Web of Science 数据库。从文献中提取的数据通过 R 和 Stata 进行分析，以评估中国 HIV/AIDS 患者耐药谱的变化趋势。
共纳入 121 篇文献。中国 HIV/AIDS 患者的联合 PDR 和 ADR 分别为 5.56%（95%CI：4.77%-6.41%）和 51.33%（95%CI：47.57%-55.38%）。时间趋势分析显示 PDR 呈上升趋势。不同样本来源的 ADR 存在显著差异，中部地区的 ADR 高于其他地区。男男性行为者（MSM）中的 PDR 低于全人群，而 MSM 的 ADR 则远高于全人群。
中国的 PDR 呈上升趋势，超过了 5%的警戒线，但仍处于全球低水平。ADR 稳定，处于全球中等水平以下；中国全面推广的免费抗逆转录病毒治疗（ART）仍在发挥持久作用。MSM 是耐药高风险人群，应采用有针对性的治疗策略。
