中国初始接受抗病毒治疗病毒学失败的HIV/AIDS患者耐药情况的Meta分析

Drug resistance in na?ve HIV/AIDS virological treatment-failed population in China: A Meta-analysis

目的了解中国初始接受ART病毒学失败HIV/AIDS患者的耐药情况。方法检索中国知网、万方、中国生物医学、Pubmed以及web of science等数据库,并对符合纳入条件的文献进行质量评价和原始数据提取,根据异质性检验的结果选择相应模型进行Meta分析、累积Meta分析和Meta回归分析,分析使用R软件和STATA软件。结果共纳入文献35篇。病毒学失败HIV/AIDS初治患者的总耐药比例为54.78%(95%CI:51.37%~58.18%);NNRTI耐药率为49.13%(95%CI:44.64%~53.61%);NRTI耐药率为36.45%(95%CI:32.95%~39.96%);PI耐药率为2.77%(95%CI:2.06%~3.40%)。累积Meta及时间趋势检验结果提示除PI呈上升趋势外,其余三类均呈下降趋势;且各耐药率在不同特征人群和不同样本来源间存在差异。结论中国目前接受ART的病毒学失败HIV/AIDS初治人群各耐药率在世界上处于中等偏下水平,且呈现下降趋势,但还需要采取多方面措施以减少治疗失败的发生。

Objective To investigate the status of drug resistance among na?ve HIV/AIDS virological treatmentfailed population in China. Methods The databases of CNKI, Wanfang, SinoMed, PubMed, and Web of Science were searched. The quality evaluation and original data extraction were carried out for the literature meeting the inclusion criteria. According to the heterogeneity test results, the corresponding models were selected for Meta-analysis, cumulative Meta-analysis, and Meta-regression analysis, and all the analyses were performed by R and STATA software. Results A total of 35 research were included. The total drug resistance percentage among the na?ve HIV/AIDS virological treatment-failed population was 54.78%(95%CI: 51.37%-58.18%). The drug resistance percentage of NRTI, NNRTI, and PI was36.45%(95%CI: 32.95%-39.96%), 49.13%(95%CI: 44.64%-53.61%) and 2.77%(95%CI: 2.06%-3.40%), respectively.Cumulative Meta and temporal trend test results indicated that PI showed an upward trend, while the other three categories showed a downward trend. There were differences in drug resistance percentage among different populations and different sample source groups. Conclusion The drug resistance percentage among the na?ve HIV/AIDS virological treatmentfailed population in China was in the lower middle range worldwide, and the overall trend was decreasing, but more measures are needed to reduce the incidence of treatment failure.