摘要
目的研究艾滋病抗病毒治疗中HIV低病毒血症对后续病毒学失败的影响。方法从中国艾滋病综合防治数据信息管理系统下载云南省艾滋病抗病毒治疗队列2004年1月1日至2018年12月31日随访数据进行回顾性观察研究。在一线治疗队列(不含克立芝)和二线治疗队列(含克立芝)中,将数据分为低病毒血症组与无低病毒血症组,对不同水平和不同频率的患者之间的风险比(HR)采用多因素Cox回归分析进行比较。结果93944例病例纳入分析。一线治疗队列中,与无低病毒血症病例相比,51~199 copies/mL组发生病毒学失败的风险没有变化,200~399 copies/mL组提高到1.39倍,400~999 copies/mL组提高到2.02倍。单独一次(HR=1.28,95%CI:1.21~1.36,P<0.001)、连续两次(HR=1.38,95%CI:1.22~1.55,P<0.001)、连续多次(HR=1.76,95%CI:1.48~2.10,P<0.001)发生低病毒血症病例发生病毒学失败的风险逐渐增加;在二线治疗队列中,与无低病毒血症病例相比,51~199 copies/mL组发生病毒学失败的风险没有变化,200~399 copies/mL组提高到1.33倍,400~999 copies/mL组提高到2.26倍。单独一次(HR=1.27,95%CI:1.11~1.46)、连续两次(HR=1.38,95%CI:1.02~1.88)发生低病毒血症的病例病毒学失败的风险在增加。结论200~999 copies/mL或单独一次、连续发生的低病毒血症与后续病毒学失败相关,使之发生风险升高。
Objective To learn about the impact of HIV low⁃level viraemia on subsequent virological failure in people living with HIV/AIDS undergoing antiretroviral therapy(ART).Methods A retrospective observational study was conducted based on the data of Yunnan′s cases extracted from National HIV/AIDS Comprehensive Information Management System from January 1,2004 to December 31,2018.Multivariate Cox regression was used to analyze the Hazard Ratio(HR)of virological failure in patients with different levels and frequencies of low⁃level viraemia compared with those without occurrence of low⁃level viraemia.They were divided into first⁃line ART cohort(regimen without LPV/r)and second⁃line ART cohort(regimen with LPV/r).Results A total of 93,944 cases were included in the analysis.In the first⁃line treatment cohort,compared with that without low⁃level viraemia,the risk rate of virological failure in the 51~199 copy/mL group was the same,but 1.39 times increased in the 200~399 copy/mL group,and 2.02 times in the 400~999 copy/mL group.Regarding to the frequencies of low viraemia occurrence,the risk of virological failure was gradually increased in cases suffering from low⁃level viraemia once(HR=1.28,95%CI:1.21~1.36,P<0.001),twice consecutively(HR=1.38,95%CI:1.22~1.55,P<0.001)and several times consecutively(HR=1.76,95%CI:1.48~2.10,P<0.001).In the second⁃line treatment cohort,the risk of virological failure was unchanged in the 51~199 copy/mL group,1.33 times increased in the 200~399 copy/mL group,and 2.26 times in the 400~999 copy/mL group,when compared with cases without low⁃level virae⁃mia.There was an increased risk of virological failure in cases suffering from low⁃level viraemia once(HR=1.27,95%CI:1.11~1.46)and twice consecutively(HR=1.38,95%CI:1.01~1.88).Conclusion The ART cases suffering from viraemia with 200⁃999 copy/mL,or suffering from viraemia for once or or two or more times have the increased risk of subsequent virological failure.
作者
安靓
劳云飞
唐松源
AN Jing;LAO Yunfei;TANG Songyuan(Yunnan Provincial Infectious Disease Hospital,Yunnan AIDS Care Center/AIDS Clinical Management Office,Kunming 650301,China;Kunming Medical University,Kunming 650500,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第16期2102-2108,共7页
The Journal of Practical Medicine
基金
云南省科技厅昆明医科大学应用基础研究联合专项资金项目(编号:202001AY070001⁃105)。
关键词
艾滋病
抗病毒治疗
低病毒血症
病毒学失败
HIV/AIDS
antiretroviral therapy
low⁃level viraemia
virological failure
