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2012 - 2020年韩国人类免疫缺陷病毒感染者中抗逆转录病毒药物的耐药趋势

Resistance Trends of Antiretroviral Agents in People with Human Immunodeficiency Virus in Korea, 2012 - 2020.

作者信息

Oh Sang-Min, Bang Jihwan, Park Sang-Won, Lee Eunyoung

机构信息

Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea.

Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

Infect Chemother. 2023 Sep;55(3):328-336. doi: 10.3947/ic.2022.0150. Epub 2023 May 4.

Abstract

BACKGROUND

Domestic data on antiretroviral drug (ARV) resistance are limited, while alterations in ARV resistance are expected as the incidence of human immunodeficiency virus (HIV) infection increases. We evaluated the ten-year change in ARV resistance in people with HIV (PWH) in Korea.

MATERIALS AND METHODS

Adults aged ≥19 years and diagnosed with HIV infection between January 2010 and December 2020 at a 750-bed municipal hospital were retrospectively reviewed. Data on clinical characteristics and resistance mutation test results were collected. The study population was divided into three-year intervals according to diagnosed year and their clinical characteristics were compared.

RESULTS

A total of 248 PWH were analyzed, and ARV resistance was detected in 30 of them (12.1%). Resistance was detected most frequently in PWH aged ≤29 years (16, 6.5%), and the median percentage of resistance detection per year was 14.3% (interquartile range, 12.7 - 16.1). The trend of the overall prevalence of ARV resistance mutations slightly decreased and then increased over time (15.3% in 2012 - 2014, 9.6% in 2015 - 2017, and 12.9% in 2018 - 2020). The prevalence of the non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance markedly decreased over time (15.3% in 2012 - 2014, 8.7% in 2015 - 2017, and 2.4% in 2018-2020), while that of protease inhibitor (PI) and integrase strand transfer inhibitor (INSTI) increased from 0 until 2018 to 3.5% and 8.2% in 2018 - 2020, respectively.

CONCLUSION

The trend of NNRTI resistance has decreased over time, and resistance to PIs and INSTIs increased from 2018. Therefore, continuous monitoring of ARV resistance pattern is necessary.

摘要

背景

关于抗逆转录病毒药物(ARV)耐药性的国内数据有限,而随着人类免疫缺陷病毒(HIV)感染发病率的增加,预计ARV耐药性会发生变化。我们评估了韩国HIV感染者(PWH)中ARV耐药性的十年变化情况。

材料与方法

对2010年1月至2020年12月期间在一家拥有750张床位的市级医院确诊感染HIV的≥19岁成年人进行回顾性研究。收集临床特征和耐药性突变检测结果的数据。根据诊断年份将研究人群分为三年间隔,并比较他们的临床特征。

结果

共分析了248例PWH,其中30例(12.1%)检测到ARV耐药性。耐药性在年龄≤29岁的PWH中检测最为频繁(16例,6.5%),每年耐药性检测的中位数百分比为14.3%(四分位间距,12.7 - 16.1)。ARV耐药性突变的总体流行趋势随时间略有下降然后上升(2012 - 2014年为15.3%,2015 - 2017年为9.6%,2018 - 2020年为12.9%)。非核苷类逆转录酶抑制剂(NNRTI)耐药性的流行率随时间显著下降(2012 - 2014年为15.3%,2015 - 2017年为8.7%,2018 - 2020年为2.4%),而蛋白酶抑制剂(PI)和整合酶链转移抑制剂(INSTI)的耐药性从2018年之前的0分别增至2018 - 2020年的3.5%和8.2%。

结论

NNRTI耐药性的趋势随时间下降,对PI和INSTI的耐药性从2018年开始增加。因此,有必要持续监测ARV耐药模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c9b/10551708/7d459a0cf452/ic-55-328-g001.jpg

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