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目的了解湖南省艾滋病抗病毒治疗失败病例耐药情况,分析其特点和影响因素。方法对治疗时间在6个月以上,且病毒载量检测>1 000拷贝/ml的52例病人进行耐药检测,将耐药结果结合病人的随访和检测数据进行分析,探讨病例耐药特点和可能的影响因素。结果 52例病人中,27例存在低度以上的耐药,25例未发现耐药,核苷类和非核苷类耐药最为常见,对蛋白酶类药品未发现耐药。耐药个案的治疗方案中,D4T+3TC+NVP最常见,占51.9%,其次是AZT+3TC+NVP方案,占25.9%。治疗时间在12~24个月的所占比例最大,占37%,其次是36个月以上的,占29.6%。耐药病例与非耐药病例的分组检验提示耐药组与非耐药组抗病毒治疗时间差异有统计学意义,与非耐药组相比,耐药组治疗时间较长。结论治疗失败可能的原因主要是依从性不良和耐药,目前一线治疗方案中的药物都有不同程度的耐药出现,加强依从性教育、早期开展治疗可减少或延缓治疗失败和继发性耐药的发生。
Objective To understand the drug resistance of HIV / AIDS failure in Hunan Province and analyze its characteristics and influencing factors. Methods Fifty-two patients whose treatment time was over 6 months and whose viral load was> 1 000 copies / ml were tested for drug resistance. The drug resistance results were analyzed with the follow-up and test data of the patients to explore the characteristics of drug resistance and Possible influencing factors. Results Among the 52 patients, 27 cases had low-level resistance and 25 cases did not find resistance. Nucleosides and non-nucleoside resistance were the most common and no resistance to protease was found. Of the treatment-resistant cases, D4T + 3TC + NVP was the most common, accounting for 51.9%, followed by AZT + 3TC + NVP, accounting for 25.9%. Treatment time in 12 to 24 months the largest proportion, accounting for 37%, followed by 36 months or more, accounting for 29.6%. The group test of resistant cases and non-resistant cases suggested that there was significant difference in the antiviral treatment time between drug-resistant group and non-drug-resistant group. Compared with non-drug-resistant group, drug-resistant group had longer treatment time. Conclusions The possible causes of treatment failure are mainly poor compliance and drug resistance. At present, drugs in first-line treatment programs all have different levels of resistance. Compliance education is strengthened, and early treatment can reduce or delay treatment failure and secondary resistance Drugs happen.