PLoS ONE (Jan 2013)

HIV drug resistance and its impact on antiretroviral therapy in Chinese HIV-infected patients.

  • Hui Xing,
  • Yuhua Ruan,
  • Jingyun Li,
  • Hong Shang,
  • Ping Zhong,
  • Xia Wang,
  • Lingjie Liao,
  • Hanping Li,
  • Min Zhang,
  • Yile Xue,
  • Zhe Wang,
  • Bin Su,
  • Wei Liu,
  • Yonghui Dong,
  • Yanling Ma,
  • Huiqin Li,
  • Guangming Qin,
  • Lin Chen,
  • Xiaohong Pan,
  • Xi Chen,
  • Guoping Peng,
  • Jihua Fu,
  • Ray Y Chen,
  • Laiyi Kang,
  • Yiming Shao,
  • Chinese National HIVDR Surveillance and Monitoring Network

DOI
https://doi.org/10.1371/journal.pone.0054917
Journal volume & issue
Vol. 8, no. 2
p. e54917

Abstract

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BACKGROUND: Highly active antiretroviral therapy (HAART) has significantly decreased mortality among Chinese HIV patients. However, emerging HIV drug resistance (HIVDR) poses a growing threat to the long-term success and durability of HAART. METHODS: Three cross-sectional surveys were conducted across the country from 2004 to 2006, respectively. Patients completed a questionnaire and provided blood for CD4 cell count, HIV viral load (VL), and HIV resistance genotyping. Factors associated with HIVDR were identified by logistic regression. RESULTS: 3667 unique patients were included across the three surveys. Among 2826 treatment-experienced patients, median duration of treatment was 17.4 (IQR 8.6-28.4) months and HIVDR was identified in 543 (19.2%). Factors significantly associated with HIVDR included ART drug distribution location, CD4 cell count, initial HAART regimen, self-reported medication adherence, and province. CONCLUSIONS: Virologic failure increased over time on therapy but a significant proportion of patients in failure had no resistance mutations identified, suggesting that treatment adherence is suboptimal and must be emphasized. Due to the significantly higher risk of HIVDR in certain provinces, additional steps to reduce HIVDR should be taken.