Retrospective study on the treatment effect of second-line antiretroviral therapy for acquired immunodeficiency syndrome patients in Henan Province from 2009 to 2013

Abstract

Objective To evaluate the efficacy and tolerance of antiretroviral therapy (ART) regimen containing lopinavir/ritonavir (LPV/r) as a second-line regimen. Methods Data of acquired immunodeficiency syndrome (AIDS) patients who have received the first-line therapy for over a year and changed to the second-line antiviral therapy regimen containing LPV/r for more than one year were collected retrospectively from the database of free antiviral therapy in Henan Province from January 1, 2009 to December 31, 2013. Based on the viral load inhibition status after the alteration of the regimen, the patients were assigned to virology failure with first-line therapy group, and successful viral inhibition but poor immunological reconstruction with first-line therapy group. The variation trend of CD4+ T lymphocyte counts of the two groups in 6, 12, 24 months after changed to the second-line regimen of LPV/r, the virology inhibition rates between 6 and 12 months, 12 and 24 months, and occurrence of adverse events were analyzed. Quantitative data were analyzed by rank sum test, and qualitative data were analyzed by chi-square test. Results A total of 4 113 patients were divided into two groups, including the first-line therapy failure group (n=3 802) and poor immunological reconstruction group (n=311). At 6, 12 and 24 months after the alteration of the regimen, the CD4+ T lymphocyte counts increased gradually (all P<0.01). Between 6 and 12 months after the first-line therapy failure group changed to the second-line regimen, viral inhibition rate was 61.65%(1 408/2 284), while that 12 and 24 months was 68.91%(2 044/2 966). The incidences of adverse reaction of the two groups were 21.88%(832/3 802) and 22.19%(69/311), respectively, which were not significantly different (χ2=0.015, P=0.901). Conclusion The ART regimen containing LPV/r still has good viral inhibition effect and immunological reconstruction effect for AIDS patients who failed the initial therapy with poor immunological reconstruction. Key words: Acquired immunodeficiency syndrome; Lopinavir; Ritonavir; Viral inhibition; Immunological reconstruction