Virologic effect and drug resistance study on antiviral therapy for AIDS in Suzhou City

ObjectiveTo investigate the status of HIV antiviral suppression and drug resistance mutations in HIV/AIDS patients receiving antiretroviral therapy(ART) in Suzhou City.

MethodsHIV/AIDS patients, who were enrolled from March 1, 2005 to Dec 31, 2018 for treatment at age of 16 years or above and with ART duration of 6 months or above, were detected with venous blood for HIV viral load(VL) and genotype resistance mutation site.

ResultsA total of 2 881 patients were included for the study, of whom 2 541(88.2%) kept VL ≤ 1 000 copies/mL; 340(11.8%) were detected with VL>1 000 copies/mL; and in the latest VL detection, 2 728 patients(94.7%) ≤ 1 000 copies/mL and 153(5.3%)>1 000 copies/mL; viral failure was 5.3%.The divorced and widowed, those with base line CD4 ≤ 200 cells/mm³, duration of treatment < 1 year or ≥ 1 year but < 3 years, and those with initial treatment plan as AZT+3TC+EFV or AZT+3TC+NVP were the highest in viral failure rate, and the differences had statistical significance(P < 0.05).Of 340 with VL>1 000 copies/mL, 278 (81.8%) successfully amplified samples.Among them, 135 patients(48.6%) were detected with drug resistace mutation sites, nucleoside and non-nucleoside reverse transcriptase inhibitors being mainly resistant to drugs, and the highest mutation frequency sites being M184/I and K103N/Q, respectively.Those aged 36-45, with baseline CD4 count ≤ 200 cells/mm³ and CRF01_AE subtype had higher incidence of drug resistace, which were 53.3%, 67.9% and 55.4%, respectively.

ConclusionSuzhou City has made remarkable progress toward the viral suppression among HIV/AIDS.However, with viral losers the detection rates of drug resistacne mutation sites are high.With key population, early treatment and compliance education should be developed.VL and drug resistance monitoring should be carried out, so as to maximize the role of antiviral therapy.