HIV感染孕妇耐药状况的Meta分析

Prevalence of HIV drug resistance among pregnant women

目的了解艾滋病病毒(HIV)感染孕妇抗病毒药物耐药水平。方法检索3个数据库(万方、CNKI、Pubmed)并提取HIV感染孕妇耐药原始数据,根据异质性检验结果,选择模型对原始数据进行合并分析,应用R软件进行Meta分析。结果本次共纳入32篇文献研究。HIV感染孕妇抗病毒药物总耐药率为9.01%[95%可信区间(CI):6.51%~12.34%]。亚组分析,各耐药率存在地区及耐药类型差异,HIV感染孕妇传播性耐药率为7.47%(95%CI:5.24%~10.06%),获得性耐药性为22.75%(95%CI:15.36%~31.11%)。结论 HIV感染孕妇耐药率较高,应加强妊娠群体耐药监测和耐药基因个体检测,以便为孕妇提供个性化治疗方案,最大限度地发挥治疗效果。

Objective To assess HIV drug resistance among pregnant women by meta-analysis. Methods We searched three electronic databases(Wanfang, CNKI, Pubmed) to study HIV drug resistance of pregnant women. Abstracted drug resistance data were pooled and analyzed according to statistical test of homogeneity. Meta-analysis was performed by R software. Results A total of 32 papers were selected and the pooled rate of drug resistance was 9.01%(95%CI 6.51%-12.34%). Subgroup analysis showed that there were differences of drug resistance rates between countries and drug resistance types. The pooled rate of TDR was 7.47%(95%CI 5.24%-10.06%) and 22.75%(95%CI 15.36%-31.11%) for ADR. Conclusion The HIV drug resistance rate among pregnant women is relatively high. Population monitoring and individual detection of drug resistance genes should be strengthened among pregnant women in order to provide individualized treatment and maximize the therapeutic effect.