目的 系统评价我国HIV/AIDS患者整合酶抑制剂耐药情况.方法 从PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方和维普等数据库检索有关HIV/AIDS患者整合酶抑制剂耐药的研究,对符合纳入条件的文献进行质量评价,提取原始数据,根据异质性结果选择相应模型进行Meta分析.结果 共纳入36项研究,包括15 702例研究对象,HIV/AIDS患者整合酶抑制剂整体耐药率为1.3％(95％CI:1.1～1.6).亚组分析,CRF_01AE、B和CRF07_BC亚型耐药率分别为0.7％(95％CI:0.1～1.2)、1.2％(95％CI:0.6～1.7)和2.5％(95％CI:0.0～4.9);同性性传播人群耐药率为1.3％(95％CI:1.0～1.9),异性性传播人群耐药率为0.9％(95％CI:0.2～1.5);2015-2019年和2020-2022年耐药率均为1.4％.本研究共发现157个整合酶抑制剂耐药突变位点,以E157Q、E138A/K/T和Q148R/H为主,占比分别为21.0％、16.6％和10.2％.结论 我国HIV/AIDS患者整合酶抑制剂耐药率处于低水平,CRF07_BC亚型及同性性传播人群耐药率较高.随着整合酶抑制剂药物的应用,应加强耐药监测,为优化治疗方案提供参考.
Drug resistance to integrase inhibitors among HIV/AIDS patients in China:A systematic review and meta-analysis
Objective To systematically evaluate the prevalence of drug resistance to integrase strand transfer inhibitors(INSTIs)among HIV/AIDS patients in China.Methods The studies on drug resistance to INSTIs among HIV/AIDS patients in China were retrieved from various databases,including PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Internet(CNKI),Wanfang Data Knowledge Service Platform,and VIP Chinese Journal Service Platform.The study conducted a qualitative analysis of the literature that met the inclusion criteria,followed by the extraction of raw data.Based on the observed heterogeneity,the appropriate model was selected for conducting a meta-analysis.Results A total of 36 studies,including 15 702 individuals,were included.The results showed that 1.3％(95％CI:1.1-1.6)of HIV/AIDS patients had drug resistance to INSTIs.Subgroup analysis revealed that the drug resistance rates for CRF_01AE,subtype B,and CRF07_BC were 0.7％(95％CI:0.1-1.2),1.2％(95％CI:0.6-1.7)and 2.5％(95％CI:0.0-4.9),respectively.The prevalence of drug resistance was 1.3％(95％CI:1.0-1.9)for homosexual individuals,and 0.9％(95％CI:0.2-1.5)for heterosexual individuals.The resistance rates were both 1.4％for the periods of 2015-2019 and 2020-2022.A total of 157 drug resistance mutations related to INSTIs were identified in this study.The major mutations identified were E157Q,E138A/K/T,and Q148R/H,accounting for 21.0％,16.6％,and 10.2％,respectively.Conclusions The prevalence of drug resistance to INSTIs among HIV/AIDS patients in China is relatively low,but it is higher in subtype CRF07_BC and homosexual individuals are higher.With the increasing usage of INSTIs,it is essential to strengthen resistance monitoring to optimize treatment strategies.
HIV/AIDSintegrase strand transfer inhibitors(INSTIs)drug resistancemeta-analysis
NETL
NSTL
万方数据
