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目的 :探讨江苏省部分地区HIV阳性的男男性行为者(men who have sex with men,MSM)抗病毒治疗耐药发生情况及其影响因素。方法:采用前瞻性动态队列研究,纳入符合标准的治疗者随访观察,计算基因型耐药发病密度,用COX回归模型探讨发生耐药的影响因素。结果:本研究共纳入符合标准的MSM 407例,总观察人时为845.77人年,随访期间共有23例发生基因型耐药,发病密度为2.72/100人年。多因素COX回归分析显示治疗前CD4+T淋巴细胞计数≤200个/μL、治疗起始用药方案是发生基因型耐药的危险因素。结论:江苏省参加抗病毒治疗的MSM耐药率处在较低水平,建议对该人群实行早治疗策略,治疗起始方案推荐优先选用含依非韦伦(EFV)的方案。
Objective: To investigate the incidence and influencing factors of antiviral drug resistance in HIV-positive men who have sex with men (MSM) in some areas of Jiangsu Province. Methods: A prospective, dynamic cohort study was conducted. Follow-up and follow-up of eligible therapies were included in the study to calculate the incidence of genotypic drug resistance and to explore the influencing factors of drug resistance by COX regression model. RESULTS: A total of 407 MSMs were included in the study, with a total of 845.77 person-years. During the follow-up period, 23 patients were genotype-resistant with a disease incidence of 2.72 / 100 person-years. Multivariate COX regression analysis showed that the CD4 + T lymphocyte count before treatment was less than or equal to 200 / μL. The treatment regimen was the risk factor of genotypic drug resistance. Conclusion: MSM resistance rate of antiviral treatment in Jiangsu Province is at a low level, and it is suggested that early treatment strategies should be applied to this population. The initial regimen of EF is recommended to be preferentially used.