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首页> 外文期刊>AIDS Research and Human Retroviruses >Burden of Nonnucleoside Reverse Transcriptase Inhibitor Resistance in HIV-1 -Infected Patients: A Systematic Review and Meta-Analysis
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Burden of Nonnucleoside Reverse Transcriptase Inhibitor Resistance in HIV-1 -Infected Patients: A Systematic Review and Meta-Analysis

机译:HIV-1感染患者的非核苷逆转录酶抑制剂耐药性负担:系统评价和荟萃分析

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The prevalence of HIV drug resistance varies with geographic location, year, and treatment exposure. This study generated yearly estimates of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance in treatment-naive (TN) and treatment-experienced (TE) patients in the United States (US), Europe (EU), and Canada. Studies reporting NNRTI resistance identified in electronic databases and 1! conferences were analyzed in'three groups: (1) TN patients in one of four geographic regions [US, Canada, EU countries with larger surveillance networks ("EU1"), and EU countries with fewer data ("EU2")]; (2) TE patients from any region: and (3) TN patients failing NNRTI-based treatments in clinical trials. Analysis data included 158 unique studies from 22 countries representing 84 cohorts of TN patients, 21 cohorts of TE patients, and 8 trials reporting resistance at failure. From 1995 to 2000, resistance prevalence in TN patients increased in US and EU! from 3.1% to 7.5% and 0.8% to 3.6%, respectively. Resistance in both regions stabilized in 2006 onward. Little resistance was identified in EU2 before 2000, and increased from 2006 (5.0%) to 2010 (13.7%). One TN Canadian study was identified and reported resistance of 8.1% in 2006. Half of TN clinical trial patients had resistance after treatment failure at weeks 48-144. Resistance in TE patients increased from 1998 (10.1%) to 2001 (44.0%), then decreased after 2004. Trends in NNRTI resistance among TN patients show an increased burden in the US and some EU countries compared to others. These findings signify a need for alternate first-line treatments in some regions.
机译:HIV耐药性的发生率随地理位置,年份和治疗暴露而变化。这项研究每年对美国(US),欧洲(EU)和加拿大的未接受治疗(TN)和具有治疗经验(TE)的患者的非核苷类逆转录酶抑制剂(NNRTI)耐药性进行估算。研究报告了在电子数据库中发现的NNRTI抗性1!将会议分为三个组进行了分析:(1)TN病人位于四个地理区域之一[美国,加拿大,具有较大监视网络的欧盟国家(“ EU1”)和具有较少数据的欧盟国家(“ EU2”)]; (2)来自任何地区的TE患者:和(3)在临床试验中基于NNRTI的治疗失败的TN患者。分析数据包括来自22个国家的158项独特研究,分别代表84例TN患者,21例TE患者和8项报告失败耐药性的试验。从1995年到2000年,美国和欧盟的TN患者抵抗力患病率呈上升趋势!分别从3.1%至7.5%和0.8%至3.6%。 2006年以后,这两个地区的阻力都趋于稳定。在2000年之前,EU2的抵抗力很小,从2006年(5.0%)上升到2010年(13.7%)。确定了一项TN加拿大研究,2006年报告耐药率为8.1%。TN临床试验患者中有一半在治疗后第48-144周出现耐药。 TE患者的耐药性从1998年(10.1%)增加到2001年(44.0%),然后在2004年之后下降。TN患者中NNRTI耐药性的趋势表明,与其他国家相比,美国和某些欧盟国家的负担增加。这些发现表明在某些地区需要替代一线治疗。

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