Incidence and correlates of HIV-1 drug resistance among men who have sex with men on highly active antiretroviral therapy:a prospective cohort study in Jiangsu Province,China
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摘要:
目的:探讨江苏省部分地区HIV阳性的男男性行为者(men who have sex with men,MSM)抗病毒治疗耐药发生情况及其影响因素-方法:采用前瞻性动态队列研究,纳入符合标准的治疗者随访观察,计算基因型耐药发病密度,用COX回归模型探讨发生耐药的影响因素-结果:本研究共纳入符合标准的MSM 407例,总观察人时为845.77人年,随访期间共有23例发生基因型耐药,发病密度为2.72/100人年-多因素COX回归分析显示治疗前CD4+T淋巴细胞计数≤200个/μL-治疗起始用药方案是发生基因型耐药的危险因素-结论:江苏省参加抗病毒治疗的MSM耐药率处在较低水平,建议对该人群实行早治疗策略,治疗起始方案推荐优先选用含依非韦伦(EFV)的方案-
Abstract:
Objective:To investigate the incidence and correlates of HIV-1 drug resistance among men who have sex with men(MSM)on highly active antiretroviral therapy (HAART). Methods:We conducted a prospective cohort study in Jiangsu province to estimate the incidence of HIV-1 drug resistance (HDR). Cox regression model was used to investigate the correlations of HDR. Results:During the follow-up period,23 MSM acquired drug resistance,and the incidence was 2.72 per 100 person-years. The independent risk factors of HDR were the CD4+T cell count (less than 200 copies/μl)before ART (HR:3.210;95%CI:1.333~7.733),and the use of nevirapine(NVP)on initial regimen (HR:2.852;95%CI:1.194~6.817). Conclusion:The incidence of HDR among MSM on ART was low. Early treatment of MSM infected with HIV-1 was recommended according to our study. It’s better to use EFV rather than NVP when initiate ART.
