Abstract
BackgroundA critical indicator of the future success of highly active antiretroviral therapy (HAART) is the incidence of HIV drug resistance, which has not been studied in China on the national scale.MethodsHIV drug resistance baseline survey was conducted in the eight provinces with the largest numbers of patients on HAART in 2009, and a prospective cohort study with 12-month follow-up was completed in 2010. Patients completed an interviewer-administrated questionnaire and provided blood for CD4+ T-lymphocyte count (CD4 count), HIV viral load (VL), and HIV drug resistance genotyping. Factors associated with incidence of HIVDR were identified by Cox regression analysis.ResultsThe overall prevalence of HIV RNA ≥1000 copies/ml and HIVDR at baseline was 12.4% and 5.6%, respectively. Incidence of HIVDR in the one year follow-up was 3.5 per 100 person years. Independently associated factors were started treatment with a didanosine-based regimen, received care at township hospital or village clinic, low baseline CD4 counts, and high baseline VL.ConclusionsThe incidence of HIVDR in China was higher than that of some developed countries. China urgently needs to provide comprehensive education and training to doctors at village clinics and township hospitals to improve quality community-based care and treatment.
Highlights
Since the introduction of combination drug regimens to treat human immunodeficiency virus (HIV) infection, known as highly active antiretroviral therapy (HAART), the rates of HIV-related morbidity and mortality have been markedly reduced. [1,2] the presence of antiretroviral drug resistance mutations in the infecting viruses may hamper the effectiveness of antiretroviral treatment (ART) because the mutations reduce the chances of full viral suppression
Previous studies on the prevalence of HIV drug resistance (HIVDR) in China and their associated factors [4,5] have served as assessments of the HIVDR consequences of China’s National Free Antiretroviral Treatment Program (NFATP)
A few studies have investigated HIVDR incidence in limited risk populations, which showed that the crude incidence of both multidrug resistance and full-drug-class has decreased over time. [6,7,8] In this study, we aim to evaluate the incidence rate of HIVDR in China as well as to identify their associated factors
Summary
Since the introduction of combination drug regimens to treat human immunodeficiency virus (HIV) infection, known as highly active antiretroviral therapy (HAART), the rates of HIV-related morbidity and mortality have been markedly reduced. [1,2] the presence of antiretroviral drug resistance mutations in the infecting viruses may hamper the effectiveness of antiretroviral treatment (ART) because the mutations reduce the chances of full viral suppression. Since the introduction of combination drug regimens to treat human immunodeficiency virus (HIV) infection, known as highly active antiretroviral therapy (HAART), the rates of HIV-related morbidity and mortality have been markedly reduced. Previous studies on the prevalence of HIV drug resistance (HIVDR) in China and their associated factors [4,5] have served as assessments of the HIVDR consequences of China’s National Free Antiretroviral Treatment Program (NFATP). Incidence of HIVDR is a critical indicator of the future success of HAART but currently remains poorly studied in China. A critical indicator of the future success of highly active antiretroviral therapy (HAART) is the incidence of HIV drug resistance, which has not been studied in China on the national scale
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