Impact of HIV Pretreatment Drug Resistance on Secondary Transmission Through Treatment Dropout: A Prospective Population-Based Study in Southwestern China.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2025-05-06 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S516513

Yi Chen, Xiaoshan Xu, Huanhuan Chen, Xiangjun Zhang, Qiuying Zhu, Shujia Liang, Hui Xing, Lingjie Liao, Yi Feng, Yiming Shao, Yuhua Ruan, Guanghua Lan, Jianjun Li

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引用次数: 0

Abstract

Objective: Discontinuation of antiretroviral treatment (ART) raised drug resistance and failure of Human Immunodeficiency Virus (HIV) virological suppression. The study aimed to assess the relationship between pretreatment drug resistance (PDR) and ART dropout, as well as the relationship between HIV treatment dropout and HIV secondary transmission.

Methods: This study included all eligible participants from a local surveillance database in southwestern China between 2014 and 2021. The PDR prevalence trend was assessed using trend Chi-square tests within a consecutive cross-sectional design (N = 3060). Cox proportional hazards model was used to investigate the relationship between PDR and the risk of treatment dropout within a cohort design. Generalized Estimating Equations model was applied to explore the association between treatment dropout and HIV secondary transmission within a longitudinal genetic network study design. (N = 5094).

Results: The overall PDR prevalence was 6.2%, analyzing a study sample of 3060 individuals with HIV/AIDS. Specifically, the prevalence of PDR to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) was 3.6%, 1.4%, and 1.1%, respectively. Yearly difference in prevalence was not identified. The independent association between PDR to NNRTIs and treatment dropout was significant (adjusted hazard ratio: 2.55, 95% CI 1.52-4.29). Among 5094 newly diagnosed HIV cases, participants who dropped out did not show a significant difference in HIV secondary transmission compared to those not on ART (adjusted odds ratio: 1.15, 95% CI 0.74-1.79).

Conclusion: PDR to NNRTIs may contribute to HIV secondary transmission through treatment dropout. It is imperative to offer comprehensive and advanced HIV care for all individuals with HIV, enhance treatment and medication adherence, and closely monitor PDR prevalence.

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HIV预处理耐药对通过放弃治疗而继发传播的影响：中国西南地区一项基于人群的前瞻性研究

目的：停止抗逆转录病毒治疗（ART）增加了耐药性和人类免疫缺陷病毒（HIV）病毒学抑制的失败。本研究旨在探讨预处理耐药（PDR）与ART中途退出的关系，以及HIV治疗中途退出与HIV继发传播的关系。方法：本研究纳入了2014年至2021年中国西南地区当地监测数据库中所有符合条件的参与者。在连续横断面设计中，使用趋势卡方检验评估PDR的流行趋势（N = 3060）。采用Cox比例风险模型在队列设计中研究PDR与治疗退出风险之间的关系。在纵向遗传网络研究设计中，应用广义估计方程模型来探讨治疗中途退出与HIV继发传播之间的关系。（n = 5094）。结果：在3060例HIV/AIDS患者的研究样本中，PDR的总体患病率为6.2%。具体来说，非核苷类逆转录酶抑制剂（NNRTIs）、核苷类逆转录酶抑制剂（NRTIs）和蛋白酶抑制剂（pi）的PDR患病率分别为3.6%、1.4%和1.1%。患病率的年度差异尚未确定。PDR与NNRTIs与治疗退出之间存在显著的独立关联（校正风险比：2.55,95% CI 1.52-4.29）。在5094例新诊断的HIV病例中，与未接受抗逆转录病毒治疗的患者相比，退出治疗的参与者在HIV继发传播方面没有显着差异（校正优势比：1.15,95% CI 0.74-1.79）。结论：nnrti患者的PDR可能通过治疗退出导致HIV继发传播。必须为所有艾滋病毒感染者提供全面和先进的艾滋病毒护理，加强治疗和药物依从性，并密切监测PDR的流行情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.