...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>AIDS >Detection of HIV drug resistance during antiretroviral treatment and clinical progression in a large European cohort study.
【24h】

Detection of HIV drug resistance during antiretroviral treatment and clinical progression in a large European cohort study.

机译：在一项大型的欧洲队列研究中，在抗逆转录病毒治疗期间检测HIV耐药性以及临床进展。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE(S): To investigate the relationship between detection of HIV drug resistance by 2 years from starting antiretroviral therapy and the subsequent risk of progression to AIDS and death. DESIGN: Virological failure was defined as experiencing two consecutive viral loads of more than 400 copies/ml in the time window between 0.5 and 2 years from starting antiretroviral therapy (baseline). Patients were grouped according to evidence of virological failure and whether there was detection of the International AIDS Society resistance mutations to one, two or three drug classes in the time window. METHODS: Standard survival analysis using Kaplan-Meier curves and Cox proportional hazards regression model with time-fixed covariates defined at baseline was employed. RESULTS: We studied 8229 patients in EuroSIDA who started antiretroviral therapy and who had at least 2 years of clinical follow-up. We observed 829 AIDS events and 571 deaths during 38,814 person-years of follow-up resulting in an overall incidence of new AIDS and death of 3.6 per 100 person-years of follow-up [95% confidence interval (CI):3.4-3.8]. By 96 months from baseline, the proportion of patients with a new AIDS diagnosis or death was 20.3% (95% CI:17.7-22.9) in patients with no evidence of virological failure and 53% (39.3-66.7) in those with virological failure and mutations to three drug classes (P = 0.0001). An almost two-fold difference in risk was confirmed in the multivariable analysis (adjusted relative hazard = 1.8, 95% CI:1.2-2.7, P = 0.005). CONCLUSION: Although this study shows an association between the detection of resistance at failure and risk of clinical progression, further research is needed to clarify whether resistance reflects poor adherence or directly increases the risk of clinical events via exhaustion of drug options.
机译：目的：调查从开始抗逆转录病毒治疗开始的2年内检测到HIV耐药性与随后发展为艾滋病和死亡风险之间的关系。设计：病毒学衰竭定义为从开始抗逆转录病毒治疗（基线）开始的0.5到2年内，两次连续的病毒载量超过400拷贝/ ml。根据病毒学失败的证据以及在时间窗口中是否检测到国际艾滋病协会对一，二或三种药物类别的耐药突变对患者进行分组。方法：采用Kaplan-Meier曲线和Cox比例风险回归模型进行标准生存分析，并在基线定义了固定时间的协变量。结果：我们在EuroSIDA中研究了8229例开始抗逆转录病毒治疗且至少有2年临床随访的患者。在38,814人年的随访期间，我们观察到829起艾滋病事件和571例死亡，导致新艾滋病的总发病率和每100人年的随访死亡3.6人[95％置信区间（CI）：3.4-3.8 ]。从基线开始的96个月，没有病毒学失败证据的艾滋病新诊断或死亡患者的比例为20.3％（95％CI：17.7-22.9），而病毒学衰竭患者的比例为53％（39.3-66.7）和三种药物的突变（P = 0.0001）。在多变量分析中确认了几乎两倍的风险差异（调整后的相对危险度= 1.8，95％CI：1.2-2.7，P = 0.005）。结论：尽管这项研究显示了对失败的抵抗力的检测与临床进展风险之间的关联，但仍需要进一步的研究来阐明抵抗力是反映依从性差还是通过用尽药物选择直接增加了临床事件的风险。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号