Frontiers in Public Health (Oct 2015)

Low virologic failure and drug resistance among HIV-infected patients receiving hospital-based ART while care and outreach through community in Guangxi, China

  • Shuja eLiang,
  • Zhiyong eShen,
  • Jing eYan,
  • Fuxiong eLiang,
  • Zhenzhu eTang,
  • Wei eLiu,
  • Wei eKan,
  • Lingjie eLiao,
  • Xuebing eLeng,
  • Yuhua eRuan,
  • Hui eXing,
  • Yiming eShao

DOI
https://doi.org/10.3389/fpubh.2015.00244
Journal volume & issue
Vol. 3

Abstract

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Objectives: To investigate HIV virologic suppression and drug resistance among HIV-infected patients receiving first-line antiretroviral treatment (ART) in hospitals while community care and outreach through local health workers in Guangxi, China.Design: This was a series of cross-sectional surveys from 2004 to 2012 in Guangxi, supported by the Chinese National HIVDR Surveillance and Monitoring Network Working Group.Settings: Guangxi, ChinaMethods: Demographic, ART and laboratory data (CD4+ cell count, viral load, and drug resistance) were analyzed. Factors associated with virologic suppression were identified by logistic regression analysis. Results: A total of 780 patients were included in this study. The median treatment duration was 20.6 months (IQR 6.6-35.9). Of 780 study participants, 95.4% of patients (744/780) had HIV virologic suppression. Among these, of the 143 patients who were infected through drug injection, only 10(7.0%) experienced virologic failure. and the overall prevalence of HIVDR was 2.8% (22/789). Factors associated with virologic suppression in the final multivariate models included: self-reported missing doses in the past month (compared to not missing doses in the past month, AOR=0.2, 95% CI: 0.1-0.6) and initial ART regimen without 3TC (compared to initial ART regimen with 3TC, AOR=0.2, 95% CI: 0.1-0.4). Moreover, the trend chi-square test showed that the proportion of virologic suppression increased over time from 2004 to 2012 (P=0.002).Conclusions: This study first demonstrated that HIV patients infected through various transmission routes can achieve an excellent treatment outcome in hospitals at or above the county level for free first-line ART in Guangxi. It is a important of ART education and adherence to intervention for achieving better treatment outcomes.

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