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目的了解我国静脉吸毒人群中(injecting drug user,IDU)艾滋病病毒感染者和病人(HIV/AIDS)抗病毒治疗后病毒抑制失败及耐药状况。方法利用我国耐药监测数据库取得接受抗病毒治疗的静脉吸毒HIV/AIDS的基本人口学特征、抗病毒治疗情况及病毒学数据,分析该人群治疗后病毒抑制失败和耐药发生原因。结果本研究中初始抗病毒治疗的静脉吸毒HIV/AIDS 1 395人,平均抗病毒治疗时间为23.9个月,病毒抑制失败率(病毒载量≥1 000拷贝/ml)为21.4%(298/1 395),广西和云南地区病毒抑制失败率12.2%(60/493),其他省份的病毒抑制失败率26.4%(238/902),总体耐药率为8.4%(117/1 395)。多因素logistic回归结果显示少数民族(AOR=2.1,95%CI:1.6~2.9)、最近治疗方案含LPV/r(克力芝)(AOR=3.6,95%CI:2.4~5.4)、近一个月漏服(AOR=2.0,95%CI:1.4~3.0)、开始治疗时间为2011-2013年(AOR=2.2,95%CI:1.5~3.2)的HIV/AIDS病毒抑制失败率高;年龄>35岁(AOR=0.7,95%CI:0.6~1.0)、广西和云南(AOR=0.3,95%CI:0.2~0.5)的静脉吸毒HIV/AIDS在接受抗病毒治疗后病毒抑制失败率低。结论我国静脉吸毒HIV/AIDS抗病毒治疗后病毒抑制失败率较高,但广西和云南地区治疗者的病毒抑制失败率低于其他地区。服药依从性是主要影响因素之一。
Objective To understand the failure and drug resistance of virus in HIV-infected and HIV-infected patients in China after injecting drug user (IDU). Methods The basic demographic characteristics, antiviral treatment and virological data of intravenous drug use HIV / AIDS receiving antiretroviral therapy were obtained by using the database of drug resistance surveillance in our country. The failure of virus suppression and the cause of drug resistance after treatment were analyzed. Results In the study, 1 395 HIV / AIDS patients were initially treated with antiviral therapy. The average duration of antiviral therapy was 23.9 months. The rate of viral suppression failure (viral load> 1000 copies / ml) was 21.4% (298/1 395), 12.2% (60/493) failed in Guangxi and Yunnan provinces, 26.4% (238/902) failed in other provinces, and the overall resistance rate was 8.4% (117/1 395). Multivariate logistic regression analysis showed that minority (AOR = 2.1, 95% CI: 1.6-2.9) and recent regimen included LPV / r (AOR = 3.6,95% CI: 2.4-5.4) (AOR = 2.0, 95% CI: 1.4-3.0), HIV / AIDS virus with a starting treatment time of 2011-2013 (AOR = 2.2, 95% CI: 1.5-3.2) 35 years old (AOR = 0.7, 95% CI: 0.6-1.0), and HIV / AIDS intravenous HIV / AIDS in Guangxi and Yunnan (AOR = 0.3,95% CI: 0.2-0.5) had a low rate of viral suppression after receiving antiviral therapy. Conclusions The rate of virus inhibition failure after intravenous drug use HIV / AIDS in our country is high, but the failure rate of virus in Guangxi and Yunnan area is lower than that in other areas. Compliance is the main medication one of the factors.