Analysis of drug resistance in 181 HIV/AIDS patients who failed virological treatment in JilinProvince
Objective To investigate the drug resistance of HIV-infected and human immunodeficiency virus/acquired im-mune deficiency syndrome(HIV/AIDS)patients who received antiretroviral therapy(ART),but failed virological treat-ment in Jilin Province from 2017 to 2020,and to provide evidence for evaluating the efficacy of antiretroviral treatment for AIDS.Methods The epidemiological data,drug resistance information and laboratory test results of HIV/AIDS patients who failed virological treatment in Jilin Province from 2017 to 2020 were collected from China AIDS Integrated Prevention and Control Information System,and the drug resistance of HIV/AIDS patients was analyzed by SPSS24.0 software.Results A total of 181 cases were investigated and the detection rate of drug resistance was 63.5％(115/181).The majority of patients were aged 25-45 years(54.1％)and male(95.6％)at the time of diagnosis.The majority of patients had body mass index(BM1)≤18.4 kg/m2(80.6％).The majority of WHO clinical stages were stage Ⅰ(58.0％),and the primary treatment was first-line regimen(96.7％).The duration of treatment was mainly 13-36 months(50.8％).The first CD4+T lymphocyte count:≤50/ul accounted for 17.7％,51-199/ul accounted for 24.8％,≥200/ul accounted for 57.5％,and the transmission route was mainly homosexual transmission(66.3％).81.7％of the patients had a time interval of less than 24 months from diagnosis to initiation of treatment,and 71.8％of the patients did not change the treatment regimen during treatment.The results of single factor analysis showed that:There were significant differences in gender,WHO clinical stage,initial treatment regimen,first CD4+T lymphoid count,time from diagnosis to initiation of treatment,and whether to change treatment regimen between drug resistant group and non-drug resistant group(x2=5.365,16.853,10.813,35.633,7.356,18.128,all P＜0.05).49.2％(89/181)of the subjects showed resistance to nucleoside(acid)reverse transcriptase inhibitors(NRTIs).Among them,Zidovudine(AZT)accounted for 44.2％,Stavudine(D4T)accounted for 35.9％,deoxyinosine(DDI)accounted for 3.9％,lamivudine(3TC)accounted for 3.4％,and other drugs accounted for 32.6％.The drug resistance of abacavir(ABC),emtricitabine(FTC)and Tenofovir(TDF)were 0.There were 61.3％(111/181)of patients showed resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs),of which nevirapine(NVP)accounted for 48.6％,Ripiavirin(RPV)accounted for 47.0％,efavirenz(EFV)accounted for 45.3％,Ettriverin(ETR)accounted for 27.1％,and other drugs accounted for 1.7％.1.7％(3/181)showed resistance to protease inhibitors(PIs),of which Lopinavir+ritonavir(LPV/r)accounted for 1.7％,Azanavir+ritonavir(ATV/r)accounted forl.l％,and Darunavir+Ritonavir(DRV/r)accounted for 0.6％.There were 85 NRTIs+NNRTIs drug resistant cases,accounting for 47.0％(85/181)of the total,and 3 NRTIs+NNRTIs+PIs drug resistant cases,accounting for 1.7％(3/181).Conclusion Early detection of HIV infection and rapid initiation of antiviral therapy are effective measures to reduce the rate of drug resistance.The designated medical institutions and CDC for antiviral treatment should conduct baseline laboratory examina-tion of patients,improve the timeliness of test results,conduct regular drug resistance and disease load detection during treatment,and timely and reasonable adjustment of antiviral treatment plan.
Human immunodeficiency virus/acquired immune deficiency syndromeVirological failureDrug resistanceInfluencing factor
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