抗病毒治疗病毒学失败的HIV感染/AIDS患者基因型耐药发生情况及其影响因素

Incidence of genotypic resistance and its influencing factors in HIV infected/AIDS patients with virological failure in antiretroviral therapy

目的 调查抗病毒治疗病毒学失败的HIV感染/AIDS患者基因型耐药的发生情况及其影响因素。方法 纳入首次接受抗病毒治疗并发生病毒学失败的311例HIV感染者/AIDS患者。收集所有患者的基线和随访资料,并进行基因型耐药检测。采用Logistic回归模型分析患者发生基因型耐药的影响因素。结果 共167例(53.7%)患者发生基因型耐药。基线年龄、婚姻状态、基线CD4+T淋巴细胞计数、基线病毒载量水平、依从性、治疗方案、治疗时间、基线临床分期、治疗前症状数量及机会性感染种数均是抗病毒治疗病毒学失败的HIV感染/AIDS患者发生基因型耐药的影响因素(均P<0.05)。结论 抗病毒治疗后病毒学失败的HIV感染/AIDS患者的基因型耐药发生率较高,且基因型耐药的发生受多种因素影响。

Objective To investigate the incidence of genotypic resistance and its influencing factors in HIV-infected/AIDS patients with virological failure in antiretroviral therapy.Methods A total of 311 HIV-infected/AIDS patients with virological failure in first antiretroviral therapy were enrolled.Baseline and follow-up data were collected from all the patients,and genotypic resistance testing was performed.Logistic regression model was used to analyze the factors influencing incidence of genotypic resistance in the patients.Results Genotypic resistance occurred in 167 cases(53.7%).Baseline age,marital status,baseline CD4+T lymphocyte count,baseline viral load level,adherence,therapeutic regimen,treatment duration,baseline clinical stage,number of pretreatment symptoms,species of pretreatment opportunistic infections were influencing factors of incidence of genotypic resistance in HIV-infected/AIDS patients with virological failure in antiretroviral therapy(all P<0.05).Conclusion HIV-infected/AIDS patients with virological failure in antiretroviral therapy experience a higher incidence rate of genotypic resistance,and the incidence of genotypic resistance is affected by various factors.