基于多替拉韦的抗逆转录病毒疗法的艾滋病毒感染者（PLWH）的病毒动力学：来自加纳选定艾滋病毒诊所的回顾性和前瞻性分析。

Viral kinetics among persons living with HIV (PLWH) on Dolutegravir-based antiretroviral Regimen: A retrospective and prospective analysis from selected HIV clinics in Ghana.

作者信息

Badu Nyarko Samuel, Twum Joel Adu, Obeng Aikins Sarpong, Djangba Helena Dede, Ryabinina Oksana, Kyei Foster, Kyei George Boateng, Thomford Nicholas Ekow

机构信息

Pharmacogenomics and Genomic Medicine Group, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.

Department of Molecular Biology and Biotechnology, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana.

出版信息

PLoS One. 2025 May 20;20(5):e0324360. doi: 10.1371/journal.pone.0324360. eCollection 2025.

DOI:10.1371/journal.pone.0324360

PMID:40392867

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12091835/

Abstract

BACKGROUND

Dolutegravir (DTG)-based antiretroviral therapy has demonstrated superior efficacy, tolerability, and durability when compared to other HIV treatment regimens. However, monitoring viral kinetics is critical for determining treatment efficacy and making sound judgments. The purpose of this study was to assess viral kinetics in people living with HIV (PLWH) on DTG-based ART and identify characteristics related to virologic response in the Cape Coast Metropolis, Ghana.

METHODS

Among people living with HIV (PLWH) attending HIV clinics between January 2020 and December 2023, a prospective and retrospective analysis of viral kinetics and clinical data were carried out. Data on viral loads, clinical laboratory results, ART regimen, and sociodemographic data were gathered. Viral loads analysis was undertaken using the COBAS AmpliPrep/COBAS TaqMan HIV-1 test, v2.0. Univariate and multivariate analyses were carried out to assess the variables related to virologic response.

RESULTS

Complete data was obtained for a total of 902 PLWH in this study. The average age was 45 ± 15.30 years, and 72.62% were female. The majority, 89.02% (835/902), had been on the DTG+3TC+TDF regimen. Over 60% had undetectable viral loads (<50 copies/mL). Univariate analysis shows a significant relationship between gender and virologic response, with females having a lower likelihood of virologic failure (OR: 0.60, 95% CI: 0.39-0.93, p-value = 0.024). In multivariate analysis, the duration of ART had various relationships with virologic response, with the odds ratio for two years reaching near significance (OR: 1.88, 95% CI: 0.98-3.59, p = 0.057). PLWH with viral loads >1000 copies/mL were 11.20% (101/902) while viral suppression, which was at detectable limits (>50 - ≤ 1000 cp/mL), was 13.08% (118/902) showing high rates of viral suppression.

CONCLUSION

The presence of virologic failures was of concern despite the high rates of viral suppression that DTG-based ART demonstrated. Undetectable viral suppression was higher than detectable viral suppression. Regular monitoring of viral kinetics, adherence, and comorbidities is essential to meeting the United Nations program on HIV/AIDS (UNAIDS) 95-95-95 targets and providing efficient therapeutic approaches for PLWH.

摘要

背景

与其他抗逆转录病毒治疗方案相比，基于多替拉韦（DTG）的抗逆转录病毒疗法已显示出卓越的疗效、耐受性和持久性。然而，监测病毒动力学对于确定治疗效果和做出合理判断至关重要。本研究的目的是评估在加纳海岸角大都会接受基于DTG的抗逆转录病毒治疗（ART）的艾滋病毒感染者（PLWH）的病毒动力学，并确定与病毒学反应相关的特征。

方法

在2020年1月至2023年12月期间到艾滋病毒诊所就诊的艾滋病毒感染者中，对病毒动力学和临床数据进行了前瞻性和回顾性分析。收集了病毒载量、临床实验室结果、抗逆转录病毒治疗方案和社会人口统计学数据。使用COBAS AmpliPrep/COBAS TaqMan HIV-1检测试剂盒v2.0进行病毒载量分析。进行单变量和多变量分析以评估与病毒学反应相关的变量。

结果

本研究共获得902名艾滋病毒感染者的完整数据。平均年龄为45±15.30岁，72.62%为女性。大多数人，即89.02%（835/902），采用DTG+3TC+TDF方案。超过60%的人的病毒载量检测不到（<50拷贝/毫升）。单变量分析显示性别与病毒学反应之间存在显著关系，女性病毒学失败的可能性较低（比值比：0.60，95%置信区间：0.39-0.93，p值=0.024）。在多变量分析中，抗逆转录病毒治疗的持续时间与病毒学反应有多种关系，两年的比值比接近显著（比值比：1.88，95%置信区间：0.98-3.59，p=0.057）。病毒载量>1000拷贝/毫升的艾滋病毒感染者占11.20%（101/902），而病毒抑制处于可检测限度（>50-≤1000拷贝/毫升）的占13.08%（118/902），显示出较高的病毒抑制率。