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目的了解山东省抗病毒治疗的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人的耐药发生情况,探讨其可能的影响因素。方法以2013至2014年山东省进行了耐药检测且能随访到的15岁以上的HIV感染者/AIDS耐药病人作为耐药组,在同县(市、区)选择接受抗病毒治疗的病人为对照组。对耐药组和对照组病人进行问卷调查,结合耐药检测结果,分析耐药发生情况及其可能的影响因素。结果共获得有效问卷241份,其中耐药组100份,对照组141份。经比较,耐药组和对照组病人的年龄、性别、婚姻状态、文化程度等一般人口学特征差异无统计学意义,多因素分析显示:治疗时长(月)、基线CD4+T淋巴细胞水平、最近一个月是否漏服、是否有服药监督员与耐药发生有关。耐药组中发生核苷类反转录酶抑制剂(NRTIs)类药物耐药3例,非核苷类反转录酶抑制剂(NNRTIs)类药物耐药27例,NRTIs类和NNRTIs类药物均发生耐药69例,同时发生NRTIs类、NNRTIs类和蛋白酶抑制剂(PI)类药物耐药1例。结论依从性和治疗时机与耐药发生有关。应进一步扩大检测,早发现早治疗,保持高度依从性,以保障抗病毒治疗的效果。
Objective To understand the drug resistance of patients with HIV / AIDS treated with antiviral therapy in Shandong Province and to explore the possible influencing factors. Methods Patients with HIV / AIDS-resistant and over 15 years of age who were tested for resistance in Shandong Province from 2013 to 2014 were selected as drug-resistant group. Patients receiving anti-virus therapy in the same county (city and district) For the control group. The patients in the resistant group and the control group were investigated by questionnaire, combined with the drug resistance test results to analyze the occurrence of drug resistance and its possible influencing factors. Results A total of 241 valid questionnaires were obtained, of which 100 were resistant group and 141 were control group. There were no significant differences in general demographic characteristics such as age, sex, marital status and educational level between the drug-resistant group and the control group. Multivariate analysis showed that the treatment duration (months), baseline CD4 + T lymphocyte level, Whether it has missed a recent month, and whether there is a medication supervisor who is involved in drug resistance. Among the drug-resistant groups, 3 cases were resistant to nucleoside reverse transcriptase inhibitors (NRTIs), 27 cases were resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs), and NRTIs and NNRTIs There were 69 cases of drug resistance, NRTIs class, NNRTIs class and protease inhibitor (PI) drug resistance in 1 case. Conclusion Compliance and treatment timing are related to the occurrence of drug resistance. Should further expand the testing, early detection and early treatment, to maintain a high degree of compliance, in order to protect the effectiveness of antiviral therapy.