Virological suppression failure and drug resistance in HIV-infected patients receiving antiretroviral therapy in Xihua county, Henan province

Objective To study virological suppression failure and drug resistance among HIV-infected patients receiving antiretroviral therapy in Xihua county,Henan province.Methods In August 2009,participants with HIV-infection and receiving antivretroviral therapy(ART) were investigated to collect information on socio-demographics and treatments in Xihua county.Blood samples were collected for viral load test and genotypic resistance was determined in those with a viral load of > 1 000 copies/ml,and the HIV pol was amplified and sequenced using RT-nested PCR.Results Overall,23.5% of the participants demonstrating virological failure.In a multiple logistic regression model,male(odds ratioOR=1.8,95% confidence intervalCI:1.1-3.1; P=0.0264),failing to adherence in the last month(OR=2.3,95% CI:1.2-4.2; P=0.0092),with a didanosine-based regimen currently prescribed(OR=2.3,95% CI:1.2-4.2; P=0.012 4) were significantly associated with virological failure(viral load > 1 000 copies/ml).Of the participants demonstrating virological failure,63.2%(55/87) experienced drug resistance,63.2%(55/87) and 49.3%(43/87) experienced drug resistance to nonnucleoside reverse-transcriptase inhibitor(NNRTI) and nucleoside reverse-transcriptase inhibitor(NRTI),respectively.There was no protease inhibitor resistance observed.Conclusion The rates of virological failure and drug resistance in patients receiving ART are high.Intervention measures should be taken to enhance adherence in order to improve outcomes of antiretroviral therapy.