สถานการณ์การดื้อยาต้านไวรัสเอดส์ ในโรงพยาบาลบ้านโป่ง

บทคัดย่อ

A retrospective observational study was conducted in Banpong Hospital in order to demonstrate treatment failure situation of HIV-infected and AIDS patients from December 2002 to December 2007. As a result, 140 HIV-infected patients were enrolled. There were 22 treatment failure patients with a mean (±S.D.) age of 37.4 ± 8.7 years. 59.3 percent of patients were female. The median duration of antiretroviral therapy before virological failure was 35.5 ± 17.8 months. The median CD4+ cell count at the time of virological failure was 138.5 ± 121.6 cells/mm³. The median HIV-1 RNA load at the time of virological failure was 7197.5 ± 11390.4 copies/ml. The frequencies of patients with 1’major mutation conferring drug resistance to nucleoside reverse-transcriptase inhibitors, nonnucleoside reverse-transcriptase inhibitors and protease inhibitors (Pls) were 100%, 90% and 5%, respectively. Of` the nucleoside reverse-transcriptase inhibitors resistance mutations, M184V was the most common (86%). Thymidine analogue mutations were found in 45% of patients. The distribution of nonnucleoside reverse-transcriptase inhibitors resistance mutations was as follows : Y1B1C, 50% ; K103N, 40% ; G190A, 30% ; V1 OBI, 15% 

In conclusion, strategies for prevention of HIV-1 resistance are crucial. Awareness of the problems, early detection of virological failure and appropriate management may provide more options and better treat- ment outcomes