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坦桑尼亚艾滋病患者获得性耐药突变的程度和模式以及流行的HIV-1亚型：一项系统评价和荟萃分析

The Magnitude and Patterns of Acquired Drug Resistance Mutations and Circulating HIV-1 Subtypes in HIV Patients in Tanzania, a Systematic Review and Meta-Analysis.

作者信息

Henerico Shimba, Kasang Christa, Kidenya Benson R, Sabas Deodatus, Kajogoo Violet D, Van Zyl Gert, Preiser Wolfgang, Mshana Stephen E, Kalluvya Samuel E

机构信息

Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania.

German Leprosy and Tuberculosis Relief Association (DAHW), Raiffeisenstraße 3, 97080 Würzburg, Germany.

出版信息

Viruses. 2025 Aug 6;17(8):1087. doi: 10.3390/v17081087.

DOI:10.3390/v17081087
PMID:40872801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12390731/
Abstract

The emergence and spread of HIV drug resistance mutations (DRMs) pose a threat to current and future treatment options. To inform policy, this review aimed to determine the magnitude and patterns of DRMs in patients on ART in Tanzania. A systematic literature search was conducted in MEDLINE through PubMed, Embase, and CINAHL up to December 2024. A total of 9685 HIV patients from 23 eligible studies were analyzed. The prevalence of virological failure in studies that used a threshold of >1000 and >400 copies/mL was 24.83% (95% CI: 17.85-32.53%) and 36.94% (95% CI: 24.79-50.00%), respectively. Major DRMs were observed at 87.61% (95% CI: 76.25-95.91%). A decrease in prevalence was observed in studies conducted from 2019, with a pooled prevalence of 62.15% (95% CI: 31.57-88.33%). The most frequently observed HIV-1 subtypes were subtype C at 36.20% (95% CI: 30.71-41.85%), A1 at 33.13% (95% CI: 28.23-38.20%), and subtype D at 16.00% (95% CI: 11.41-21.12%), while recombinant forms of the virus were observed at 13.29% (95% CI: 9.79-17.17%). The prevalence of DRMs against NRTIs and NNRTIs was significantly high, while that against INSTIs and PIs was low, supporting the continued use of PI- and INSTI-based regimens in Tanzania and the need for continued surveillance of DRMs.

摘要

艾滋病毒耐药性突变（DRM）的出现和传播对当前及未来的治疗选择构成了威胁。为了为政策提供依据，本综述旨在确定坦桑尼亚接受抗逆转录病毒治疗（ART）患者中DRM的程度和模式。截至2024年12月，通过PubMed、Embase和CINAHL在MEDLINE中进行了系统的文献检索。对来自23项符合条件研究的9685名艾滋病毒患者进行了分析。使用>1000拷贝/mL和>400拷贝/mL阈值的研究中，病毒学失败的患病率分别为24.83%（95%置信区间：17.85 - 32.53%）和36.94%（95%置信区间：24.79 - 50.00%）。观察到主要DRM的比例为87.61%（95%置信区间：76.25 - 95.91%）。在2019年开展的研究中观察到患病率有所下降，合并患病率为62.15%（95%置信区间：31.57 - 88.33%）。最常观察到的艾滋病毒-1亚型是C亚型，占36.20%（95%置信区间：30.71 - 41.85%），A1亚型占33.13%（95%置信区间：28.23 - 38.20%），D亚型占16.00%（95%置信区间：11.41 - 21.12%），而病毒的重组形式占13.29%（95%置信区间：9.79 - 17.17%）。对核苷类逆转录酶抑制剂（NRTI）和非核苷类逆转录酶抑制剂（NNRTI）的DRM患病率显著较高，而对整合酶链转移抑制剂（INSTI）和蛋白酶抑制剂（PI）的患病率较低，这支持了坦桑尼亚继续使用基于PI和INSTI的治疗方案以及持续监测DRM的必要性。

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