2510. Systematic Literature Review of Multiclass Resistance in Heavily Treatment Experienced Persons with HIV
Notice bibliographique
Résumé
Abstract Background Because of progress in antiretroviral therapy (ART), fewer people with HIV experience virologic failure with multiclass resistance. We sought to estimate the prevalence of multiclass resistance since the introduction of INSTI-based regimens using a systematic literature review. Methods A systematic literature search using PubMed, Embase, and the Cochrane Library was conducted of articles published since 2008, the year when INSTI-based regimens for treatment-experienced people with HIV became widely used. Bibliographies of existing literature reviews, websites of European and International organizations reporting data on HIV and AIDS, and abstracts presented from 2016–2018 at conferences were searched to identify additional relevant studies. Using predefined criteria, two reviewers independently reviewed studies reporting multiclass (three-class or greater) resistance in persons with HIV infection who are treatment experienced and were either perinatally infected or infected as adults. Studies from Western Europe, Australia, Canada and the United States (US) using any type of resistance definitions and resistance tests were included. Results A total of 441 unique articles were identified, 343 were excluded during level 1 screening and 98 articles were included for full-text review. A total of 34 articles (11 US studies, 3 from Canada, 1 from Australia, and 19 from Western European countries.) met the inclusion criteria and were included in data extraction analysis. Over the past decade, a modest decrease in the prevalence of three-class (NNRTI, NRTI, PI) resistance was observed in studies from the United States and Canada, ranging from 8.3% in 2009 to 6.7% in 2014 (Figure 1). Western European countries and Australia showed similar trends. The prevalence of 4-class resistance (including INSTIs) with virologic failure in the current treatment era is low, less than 2% (Figure 2). Conclusion The prevalence of multiclass resistance has decreased over the past decade, with three-class resistance continuing to decline and four-class resistance rare. Although the population with treatment failure and no viable options for a suppressive regimen is currently small, this group of people with HIV are in urgent need of novel treatment options. Disclosures All authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».