背景:尽管取得了显著进展,艾滋病毒对全球健康的影响仍然坚定,要求继续关注。了解三线抗逆转录病毒治疗对二线药物无反应的个体的有效性对于改善治疗策略至关重要。三线抗逆转录病毒治疗的病毒学结果因研究而异,强调需要进行稳健的全球估计。
方法:对包括PubMed、MEDLINE,国际科学索引,WebofScience,和谷歌学者,进行了。采用STATA第17版统计软件进行分析。应用随机效应模型来计算合并估计值。亚组分析,异质性,出版偏见,并进行了敏感性分析.计算预测间隔以估计未来研究将落在其中的间隔。等级工具也用于确定证据的质量。
结果:在本系统综述和荟萃分析中,纳入了15项研究,涉及1768名接受三线抗逆转录病毒治疗的HIV患者。三线抗逆转录病毒治疗的合并病毒抑制为76.6%(95%CI:71.5-81.7%)。6个月和12个月的病毒抑制率分别为75.5%和78.6%,分别。此外,三线治疗有效抑制病毒RNA拷贝数≤50拷贝/mL,≤200拷贝/mL,≤400拷贝/毫升,比率为70.7%,85.4%,和85.7%,分别。
结论:超过四分之三的接受三线抗逆转录病毒治疗的患者实现了病毒抑制。因此,改善获得和及时开始三线治疗可能会对二线治疗失败患者的生活质量产生积极影响.
Despite remarkable progress, HIV\'s influence on
global health remains firm, demanding continued attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral therapy vary from study to study, highlighting the need for robust
global estimates.
A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web of Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A random-effects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future study will fall. The GRADE tool was also used to determine the quality of the evidence.
In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95% CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore, third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400 copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.
More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression. Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life for those with second-line treatment failure.