未服用愛滋病治療藥物的新患者感染抗藥性愛滋病毒的趨勢

Drug-resistant HIV-1 in Treatment-naïve HIV-1-infected Patients

自從愛滋病抗病毒藥物開始廣泛使用後，愛滋病成為可控制的慢性病。然而抗藥性病毒株隨即於愛滋病治療藥物上市不久後，出現在服藥順從性不佳的病人體內；廣泛使用合併愛滋病治療藥物療法後，亦發現具有抗藥性的愛滋病毒株的比例也愈來愈高，特別是在核苷酸反轉錄酶抑制劑及非核苷酸反轉錄酶抑制劑等二種治療藥物具有抗藥性的愛滋病毒株。本文介紹愛滋病治療藥物的使用原則、愛滋病毒產生抗藥性的機轉、實驗室偵測病毒抗藥性的方法，以及在台灣地區位服用抗病毒藥物的愛滋病新患者感染帶有抗藥性基因的愛滋病毒的流行病學現況，希望能讓從事傳染病通報與感染管制的醫療同仁能深入了解抗藥性愛滋病毒現況及未來愛滋病治療趨勢。

With the introduction of combination antiretroviral therapy, human immunodeficiency virus (HIV) infection became controllable. Soon after antiretroviral therapy was introduced, however, drug-resistant strains of HIV-1 emerged. The rate of resistance, especially to nucleoside/nucleotide and non-nucleoside reverse-transcriptase inhibitors (NRTIs and NNRTIs), has increased rapidly with the widespread use of combination antiretroviral therapy. In this study, the antiretroviral therapy principle, antiretroviral drug resistance mechanisms, laboratory techniques, and drug resistance trends in Taiwan were reviewed.