Yuan Yuan, Xing Hui, Wang Xiao-Yu, Liu Chun-Hua, Yang Li-Ting, Zheng Ben-Feng, Wang Xia, Ruan Yu-Hua, Wang Zhe, Liu Hong-Wei, Shao Yi-Ming
Center for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2011 Jul;45(7):619-24.
To understand the prevalence of HIV-1 drug resistance and its main factors in AIDS patients receiving to HAART in Zhecheng county, Henan province.
By cross-sectional survey, 378 AIDS patients who had received the national free antiretroviral therapy from July 2003 to March 2009 in Zhecheng county of Henan were selected. All recruits were interviewed and blood samples were collected. HIV-1 viral loads were measured by real-time polymerase chain reaction, HIV genotypic resistance was determined by an in-house polymerase chain reaction to amplify the HIV-1 pol gene region.
Among 378 subjects receiving antiretroviral therapy, the prevalence of successful viral suppression was 42.9% (162/378), and HIV-1 drug resistance was detected in 47.1% (178/378) patients. The rate of resistance-associated mutations to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs) was 46.6% (176/378), 37.8% (143/378) and 1.9% (7/378), respectively. Multivariate logistic regression analysis showed that the main risk factors associated with the prevalence of drug resistance included drug non-adherence (ratio of on-time drug intake in the past month < 90%:≥ 90% = 64.5% (40/62):43.7% (138/316), OR = 2.3, 95%CI: 1.3 - 4.1), and initiation of anti-retroviral therapy (ART) with didanosine (DDI) (ART with DDI:ART with lamivudine (3TC) = 53.3% (137/257):33.9% (41/121), OR = 2.3, 95%CI = 1.1 - 4.5).
The prevalence of HIV-1 drug resistance among ART patients in Zhecheng county of Henan was high. Drug non-adherence and initiation of ART with DDI were the main factors of drug resistance.
了解河南省柘城县接受高效抗逆转录病毒治疗（HAART）的艾滋病患者中HIV-1耐药情况及其主要影响因素。
采用横断面调查方法，选取2003年7月至2009年3月在河南省柘城县接受国家免费抗逆转录病毒治疗的378例艾滋病患者。对所有入选者进行访谈并采集血样。采用实时聚合酶链反应检测HIV-1病毒载量，通过自制聚合酶链反应扩增HIV-1 pol基因区域来确定HIV基因耐药情况。
在378例接受抗逆转录病毒治疗的患者中，病毒抑制成功的比例为42.9%（162/378），47.1%（178/378）的患者检测到HIV-1耐药。对非核苷类逆转录酶抑制剂（NNRTIs）、核苷类逆转录酶抑制剂（NRTIs）和蛋白酶抑制剂（PIs）的耐药相关突变率分别为46.6%（176/378）、37.8%（143/378）和1.9%（7/378）。多因素logistic回归分析显示，与耐药发生率相关的主要危险因素包括服药依从性差（过去1个月按时服药比例<90%：≥90% = 64.5%（40/62）：43.7%（138/316），OR = 2.3，95%CI：1.3 - 4.1），以及以去羟肌苷（DDI）开始抗逆转录病毒治疗（ART）（以DDI进行ART：以拉米夫定（3TC）进行ART = 53.3%（137/257）：33.9%（41/121），OR = 2.3，95%CI = 1.1 - 4.5）。
河南省柘城县接受ART治疗的患者中HIV-1耐药发生率较高。服药依从性差和以DDI开始ART是耐药的主要因素。
