SidaSubSaharaV1, Main, Exploration, bibRecordById, PMC:5172524

Drug Resistance and Virological Failure among HIV-Infected Patients after a Decade of Antiretroviral Treatment Expansion in Eight Provinces of China

Identifieur interne : 001103 ( Main/Exploration ); précédent : 001102; suivant : 001104

Drug Resistance and Virological Failure among HIV-Infected Patients after a Decade of Antiretroviral Treatment Expansion in Eight Provinces of China

Source :

PLoS ONE [ 1932-6203 ] ; 2016.

RBID : PMC:5172524

Abstract

Background

China’s National Free Antiretroviral Treatment Program (NFATP) has substantially increased the survival rate since 2002. However, the emergence of HIV drug resistance (HIVDR) limits the durability and effectiveness of antiretroviral treatment (ART) in at risk patients.

Method

A cross-sectional survey was conducted among patients having received a median of 13.9 months of ART in eight provinces in China. Demographic and clinical information was collected, and venous blood was sampled for CD4 cell counts, measurement of the HIV viral load (VL), and HIV drug resistance (HIVDR) genotyping. Possible risk factors for HIVDR were analyzed by the logistic regression model.

Results

The study included 765 patients. Among them, 65 patients (8.5%) had virological failure (VLF) defined as ≥1,000 copies/ml. Among the individuals with VLF, 64 were successful genotyped, and of these, 33 had one or more HIVDR mutations. The prevalence of HIVDR mutations among patients receiving first-line ART was 4.3% (33/765). All of the patients with HIVDR mutations were resistant to non-nucleoside transcriptase inhibitors, 81.8% were resistant to nucleoside reverse transcriptase inhibitors, and only 3% had mutations that caused resistance to protease inhibitors. Having lower ratios of drug intake in the past month and dwelling in two southwestern provinces were factors independently associated with the emergence of HIVDR.

Conclusion

Most patients receiving first-line ART treatment achieved sound virological and immunological outcomes. However, poor adherence is still a key problem, which has led to the high rate of HIVDR. It was notable that the proportion of drug resistance widely varied among the provinces. More studies are needed to focus on adherence.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5172524

DOI: 10.1371/journal.pone.0166661
PubMed: 27997554
PubMed Central: 5172524

Affiliations:

Le document en format XML

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<author><name sortKey="Liao, Lingjie" sort="Liao, Lingjie" uniqKey="Liao L" first="Lingjie" last="Liao">Lingjie Liao</name>
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</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing</wicri:regionArea>
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<author><name sortKey="Ruan, Yuhua" sort="Ruan, Yuhua" uniqKey="Ruan Y" first="Yuhua" last="Ruan">Yuhua Ruan</name>
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</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
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<author><name sortKey="Shao, Yiming" sort="Shao, Yiming" uniqKey="Shao Y" first="Yiming" last="Shao">Yiming Shao</name>
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</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing</wicri:regionArea>
<placeName><settlement type="city">Pékin</settlement>
</placeName>
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<author><name sortKey="Xing, Hui" sort="Xing, Hui" uniqKey="Xing H" first="Hui" last="Xing">Hui Xing</name>
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</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>China’s National Free Antiretroviral Treatment Program (NFATP) has substantially increased the survival rate since 2002. However, the emergence of HIV drug resistance (HIVDR) limits the durability and effectiveness of antiretroviral treatment (ART) in at risk patients.</p>
</sec>
<sec id="sec002"><title>Method</title>
<p>A cross-sectional survey was conducted among patients having received a median of 13.9 months of ART in eight provinces in China. Demographic and clinical information was collected, and venous blood was sampled for CD4 cell counts, measurement of the HIV viral load (VL), and HIV drug resistance (HIVDR) genotyping. Possible risk factors for HIVDR were analyzed by the logistic regression model.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>The study included 765 patients. Among them, 65 patients (8.5%) had virological failure (VLF) defined as ≥1,000 copies/ml. Among the individuals with VLF, 64 were successful genotyped, and of these, 33 had one or more HIVDR mutations. The prevalence of HIVDR mutations among patients receiving first-line ART was 4.3% (33/765). All of the patients with HIVDR mutations were resistant to non-nucleoside transcriptase inhibitors, 81.8% were resistant to nucleoside reverse transcriptase inhibitors, and only 3% had mutations that caused resistance to protease inhibitors. Having lower ratios of drug intake in the past month and dwelling in two southwestern provinces were factors independently associated with the emergence of HIVDR.</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>Most patients receiving first-line ART treatment achieved sound virological and immunological outcomes. However, poor adherence is still a key problem, which has led to the high rate of HIVDR. It was notable that the proportion of drug resistance widely varied among the provinces. More studies are needed to focus on adherence.</p>
</sec>
</div>
</front>
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Drug Resistance and Virological Failure among HIV-Infected Patients after a Decade of Antiretroviral Treatment Expansion in Eight Provinces of China

Drug Resistance and Virological Failure among HIV-Infected Patients after a Decade of Antiretroviral Treatment Expansion in Eight Provinces of China

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	Le SIDA en Afrique subsaharienne (serveur d'exploration)
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