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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Profile of HIV-infected patients receiving second-line antiretroviral therapy in a resource-limited setting in Nigeria
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Profile of HIV-infected patients receiving second-line antiretroviral therapy in a resource-limited setting in Nigeria

机译：在尼日利亚资源有限的地区接受二线抗逆转录病毒疗法的艾滋病毒感染患者的概况

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Background: Second-line antiretroviral therapy (ART) accounts for lessthan5%of totalARTin resource-limited settings. We described the baseline characteristics, reasons for switch and treatment outcomes of Nigerian patients receiving second-line ART. Methods: In this retrospective cohort study we recorded the baseline characteristics of HIV-infected adults whose treatment regimen was switched from a non-nucleoside reverse transcriptase inhibitor, a first-line agent, to a protease inhibitor-based second-line regimen. The duration of follow-up was 12 months. Results: Of 4229 patients who started first-line therapy, 186 (4.4%) were switched to second-line therapy after a mean duration of 16.6±7.6 months. Their mean age was 41.8±9.6 years and 59.1% were women. The median (range) viral load andCD4 cell counts at switch were 4.7 (4.1-6.3) log10 copies/ml and 71 (6-610) cells/μl, respectively. The predominantreason for switchwas virological failure (79.0%). Only55.4%and36.6%of patientshadCD4 cell count and viral load at 12 months. About 82%, 79% and 82% of patients with available data achieved virological suppression at 3 months, 6 months and 12 months respectively (p 1/4 0.81). The proportion of patients who achieved ≥50%rise in CD4 cell count increased from55.8% at 3 months to 78.6% at 12 months (p 1/4 0.0002). Conclusion: The rate of switch to second-line therapy was low but there were good treatment outcomes among patients with available data. Attrition rate was high. Regular viral load monitoring, improved availability/affordability of second-line regimens and retention in care should become priorities in resource-limited settings.
机译：背景：二线抗逆转录病毒疗法（ART）占总ARTin资源受限设置的不到5％。我们描述了接受二线抗病毒治疗的尼日利亚患者的基线特征，转换原因和治疗结果。方法：在这项回顾性队列研究中，我们记录了HIV感染成人的基线特征，其治疗方案已从非核苷逆转录酶抑制剂（一线药物）改为基于蛋白酶抑制剂的第二线药物。随访时间为12个月。结果：在开始一线治疗的4229例患者中，平均持续时间16.6±7.6个月后，有186例（4.4％）转为二线治疗。他们的平均年龄为41.8±9.6岁，女性为59.1％。转换时的中位（范围）病毒载量和CD4细胞计数分别为4.7（4.1-6.3）log10个拷贝/ ml和71（6-610）个细胞/μl。转换的主要原因是病毒学失败（79.0％）。在12个月时，只有55.4％和36.6％的患者具有CD4细胞计数和病毒载量。大约有82％，79％和82％的现有数据患者分别在3个月，6个月和12个月时实现了病毒学抑制（p 1/4 0.81）。 CD4细胞计数上升≥50％的患者比例从3个月的55.8％增加到12个月的78.6％（p 1/4 0.0002）。结论：二线治疗的转换率低，但有数据的患者治疗效果良好。损耗率很高。定期的病毒载量监测，提高的二线治疗方案的可利用性/可负担性以及护理的保留应成为资源有限的环境中的优先事项。

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