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首页> 外文期刊>AIDS Research and Human Retroviruses >The role of toxicity-related regimen changes in the development of antiretroviral resistance.
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The role of toxicity-related regimen changes in the development of antiretroviral resistance.

机译：毒性相关方案的改变在抗逆转录病毒耐药性发展中的作用。

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In an effort to evaluate factors associated with the development of antiretroviral (ARV) resistance, we assessed the prevalence of toxicity-related regimen changes and modeled its association to the subsequent development of ARV resistance in a cohort of treatment-naive individuals initiating ARV therapy (ART). A retrospective analysis of patients initiating ART was conducted at the UAB 1917 Clinic from 1 January 2000 to 30 September 2007. Cox proportional hazards models were fit to identify factors associated with the development of resistance to >/=1 ARV drug class. Among 462 eligible participants, 14% (n=64) developed ARV resistance. Individuals with >/=1 toxicity-related regimen change (HR=3.94, 95% CI=1.09-14.21), initiating ART containing ddI or d4T (4.12, 1.19-14.26), and from a minority race (2.91, 1.16-7.28) had increased risk of developing resistance. Achieving virologic suppression within 12 months of ART initiation (0.10, 0.05-0.20) and higher pretreatment CD4 count (0.85 per 50 cells/mm(3), 0.75-0.96) were associated with decreased hazards of resistance. Changes in ART due to drug intolerance were associated with the subsequent development of ARV resistance. Understanding the role of ARV drug selection and other factors associated with the emergence of ARV resistance will help inform interventions to improve patient care and ensure long-term treatment success.
机译：为了评估与抗逆转录病毒（ARV）耐药性发展相关的因素，我们评估了与毒性有关的治疗方案变化的普遍性，并在一群初次接受抗逆转录病毒治疗的未接受过治疗的个体中，将其与随后的ARV耐药性发展进行了关联（艺术）。 2000年1月1日至2007年9月30日在UAB 1917诊所对发起抗逆转录病毒疗法的患者进行了回顾性分析。Cox比例风险模型适合确定与对> / = 1 ARV药物耐药性发生相关的因素。在462名合格参与者中，有14％（n = 64）出现了抗逆转录病毒。具有> / = 1毒性相关方案变更（HR = 3.94，95％CI = 1.09-14.21），发起包含ddI或d4T（4.12，1.19-14.26）的ART以及来自少数族裔（2.91，1.16-7.28）的个体）增加了产生抗药性的风险。在抗病毒治疗开始后的12个月内实现病毒学抑制（0.10，0.05-0.20）和更高的治疗前CD4计数（每50个细胞0.85 mm3 / mm（3），0.75-0.96）与降低抗药性相关。由于药物不耐受引起的ART变化与ARV耐药性的随后发展有关。了解抗逆转录病毒药物选择的作用以及与抗逆转录病毒耐药性出现有关的其他因素将有助于为改善患者护理和确保长期治疗成功提供信息。

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